Provider First Line Business Practice Location Address:
PMG PEDIATRIC SURGICAL GROUP
Provider Second Line Business Practice Location Address:
201 CEDAR SE SUITE 503
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:
505-224-7478
Provider Business Practice Location Address Fax Number:
505-224-7479
Provider Enumeration Date:
10/03/2006