Provider First Line Business Practice Location Address:
2100 N MARTIN LUTHER KING JR BLVD
Provider Second Line Business Practice Location Address:
EMERGENCY MEDICINE DEPARTMENT
Provider Business Practice Location Address City Name:
CLOVIS
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-765-3180
Provider Business Practice Location Address Fax Number:
601-765-2808
Provider Enumeration Date:
06/10/2005