Provider First Line Business Practice Location Address:
5901 HARPER DRIVE NE
Provider Second Line Business Practice Location Address:
PRESBYTERIAN WOUND CENTER
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87109-3587
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-823-8870
Provider Business Practice Location Address Fax Number:
505-823-8875
Provider Enumeration Date:
11/10/2006