Provider First Line Business Practice Location Address:
TAOS-PICURIS INDIAN HEALTH CENTER
Provider Second Line Business Practice Location Address:
16 SPIDER ROAD
Provider Business Practice Location Address City Name:
TAOS
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87571-6744
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-758-4224
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/22/2007