Provider First Line Business Practice Location Address:
2220 RAYMAC RD SW
Provider Second Line Business Practice Location Address:
ALBUQUERQUE PUBLIC SCHOOL - PARK MIDDLE SCHOOL
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87105-6843
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-296-9521
Provider Business Practice Location Address Fax Number:
505-296-2200
Provider Enumeration Date:
05/23/2006