Provider First Line Business Practice Location Address:
MSC10 5590
Provider Second Line Business Practice Location Address:
1 UNIVERSITY OF NEW MEXICO
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-272-2345
Provider Business Practice Location Address Fax Number:
505-272-2374
Provider Enumeration Date:
04/01/2024