Provider First Line Business Practice Location Address:
2211 LOMAS BLDS. NE
Provider Second Line Business Practice Location Address:
4TH FLOOR AMBULATORY CARE CTR
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-272-2245
Provider Business Practice Location Address Fax Number:
505-272-1109
Provider Enumeration Date:
01/09/2007