Provider First Line Business Practice Location Address:
CORNER OF UNIVERSITY AND JORDAN
Provider Second Line Business Practice Location Address:
SPEECH BLDG. ROOM 158
Provider Business Practice Location Address City Name:
LAS CRUCES
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-646-4313
Provider Business Practice Location Address Fax Number:
505-646-3140
Provider Enumeration Date:
05/17/2007