Provider First Line Business Practice Location Address:
1209 UNIVERSITY BLVD NE
Provider Second Line Business Practice Location Address:
FAMILY PRACTICE/ INTERNAL MEDICINE CLINIC
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87102-1727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-272-4400
Provider Business Practice Location Address Fax Number:
505-925-7662
Provider Enumeration Date:
06/17/2010