Provider First Line Business Practice Location Address:
MSC 10-5620 1 UNIVERSITY OF NEW MEXICO
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:
505-272-3342
Provider Business Practice Location Address Fax Number:
505-272-6692
Provider Enumeration Date:
04/03/2020