Provider First Line Business Practice Location Address:
UNIVERSITY OF NEW MEXICO
Provider Second Line Business Practice Location Address:
2211 LOMAS BLVD NE
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87106-8710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-272-6487
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/01/2005