Provider First Line Business Practice Location Address:
2600 YALE BLVD SE
Provider Second Line Business Practice Location Address:
UNMH - ASAP
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87106-4217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-994-7999
Provider Business Practice Location Address Fax Number:
505-243-0366
Provider Enumeration Date:
07/20/2011