Provider First Line Business Practice Location Address:
LA CLINICA DE FAMILIA
Provider Second Line Business Practice Location Address:
1100 S MAIN ST
Provider Business Practice Location Address City Name:
LAS CRUCES
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-824-0820
Provider Business Practice Location Address Fax Number:
505-824-1021
Provider Enumeration Date:
01/11/2007