Provider First Line Business Practice Location Address:
1700 CERRILLOS RD
Provider Second Line Business Practice Location Address:
SANTA FE INDIAN HOSPITAL
Provider Business Practice Location Address City Name:
SANTA FE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87505-3554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-988-9821
Provider Business Practice Location Address Fax Number:
505-983-6243
Provider Enumeration Date:
01/12/2006