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1992408520
ACTIVE MEDICAL GROUP LLC
FARMINGTON, NM
NPI
1992408520
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Entity Type
Organization
Authorized Contact
ASHLEY JORDAN SMITH
Nurse Practitioner
505-336-7344
Organization Subpart ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
Enumeration Date
2023-03-23
Last Update Date
2023-03-24
Business Address
ACTIVE MEDICAL GROUP LLC
4760 N BUTLER AVE STE D
FARMINGTON, NM 87401-0816
Phone number: 505-370-1201
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Mailing Address
ACTIVE MEDICAL GROUP LLC
4760 N BUTLER AVE STE D
FARMINGTON, NM 87401-0816
Phone number: 505-370-1201
Copy
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