Provider First Line Business Practice Location Address:
UNIVERSITY OF NEW MEXICO HSC 1 UNIVERSITY OF
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87131-1210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-272-4814
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2012