Provider First Line Business Practice Location Address:
PRESBYTERIAN HOSPITAL 1100 CENTRAL AVE SE
Provider Second Line Business Practice Location Address:
PMG PEDIATRIC INTENSIVISTS
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-841-1163
Provider Business Practice Location Address Fax Number:
505-724-7043
Provider Enumeration Date:
08/30/2006