Provider First Line Business Practice Location Address:
1960 N DATE ST
Provider Second Line Business Practice Location Address:
BEN ARCHER HEALTH CARE CENTER
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:
87901-3701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-341-3152
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2006