Provider First Line Business Practice Location Address:
1302 E 32ND ST
Provider Second Line Business Practice Location Address:
VA COMMUNITY CLINIC
Provider Business Practice Location Address City Name:
SILVER CITY
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88061-7252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-538-2921
Provider Business Practice Location Address Fax Number:
505-388-9260
Provider Enumeration Date:
09/26/2006