Provider First Line Business Practice Location Address:
5150 JOURNAL CENTER BLVD NE
Provider Second Line Business Practice Location Address:
DAVITA MEDICAL GROUP COUMADIN CLINIC
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87109-5900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-262-3851
Provider Business Practice Location Address Fax Number:
505-262-3851
Provider Enumeration Date:
04/12/2017