Provider First Line Business Practice Location Address:
UNIVERSITY OF NEW MEXICO MSCO6 3870
Provider Second Line Business Practice Location Address:
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:
505-277-3136
Provider Business Practice Location Address Fax Number:
505-277-2020
Provider Enumeration Date:
03/27/2020