Provider First Line Business Practice Location Address:
1101 MEDICAL ARTS NE
Provider Second Line Business Practice Location Address:
UNM SENIOR HEALTH CLINIC
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-272-1547
Provider Business Practice Location Address Fax Number:
505-925-4594
Provider Enumeration Date:
03/27/2006