Provider First Line Business Practice Location Address:
800 EAST NINTH STREET
Provider Second Line Business Practice Location Address:
SIERRA VISTA HOSPITAL
Provider Business Practice Location Address City Name:
TRUTH OR CONSEQUENCES
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-894-2111
Provider Business Practice Location Address Fax Number:
505-894-7659
Provider Enumeration Date:
04/10/2007