Provider First Line Business Practice Location Address:
1 UNIVERSITY OF NEW MEXICO
Provider Second Line Business Practice Location Address:
DEPT OF PEDIATRICS/DIVISION NEO MSC 10 5590
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:
505-272-2275
Provider Business Practice Location Address Fax Number:
505-295-4625
Provider Enumeration Date:
03/15/2007