Provider First Line Business Practice Location Address:
DEPARTMENT OF PEDIATRICS MSC10 5590
Provider Second Line Business Practice Location Address:
1 UNIVERSITY OF NEW MEXICO
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87131-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-727-8676
Provider Business Practice Location Address Fax Number:
505-925-4089
Provider Enumeration Date:
03/02/2007