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Organization
SANTA CLARA PUEBLO
Active
Organization
SANTA CLARA PUEBLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH BRUCE TAFOYA (LT. GOVERNOR)
(505) 753-7326
Entity
Organization
Contact information
Practice address
360 FOG ROAD, ESPANOLA, NM 87532
(505) 753-7326
Mailing address
P.O. BOX 580, ESPANOLA, NM 87532
(505) 753-7326
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/02/2011
Last updated
05/02/2011
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