Provider First Line Business Practice Location Address:
2200 W 21ST ST
Provider Second Line Business Practice Location Address:
SAME DAY CARE CLINIC - CLOVIS
Provider Business Practice Location Address City Name:
CLOVIS
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88101-2011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-769-7577
Provider Business Practice Location Address Fax Number:
505-769-6374
Provider Enumeration Date:
09/06/2017