Provider First Line Business Practice Location Address:
RIO ARRIBA COUNTY/ HHS ATTN: KATRINA PADILLA
Provider Second Line Business Practice Location Address:
1122 INDUSTRIAL PARK RD.
Provider Business Practice Location Address City Name:
ESPANOLA
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87532-1279
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-310-8937
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/16/2023