Provider First Line Business Practice Location Address:
LOS ALAMOS MEDICAL CENTER, 3917 WEST RD
Provider Second Line Business Practice Location Address:
SUITE M250
Provider Business Practice Location Address City Name:
LOS ALAMOS
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87544
Provider Business Practice Location Address Country Code:
UM
Provider Business Practice Location Address Telephone Number:
505-412-3367
Provider Business Practice Location Address Fax Number:
505-662-9200
Provider Enumeration Date:
01/07/2011