Provider First Line Business Practice Location Address:
800 EAST NINTH AVENUE
Provider Second Line Business Practice Location Address:
SIERRA VISTA HOSPITAL
Provider Business Practice Location Address City Name:
TRUTH OR CONSEQUENCES
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-743-1230
Provider Business Practice Location Address Fax Number:
575-894-0835
Provider Enumeration Date:
04/06/2009