Individual
AMY LONGFELLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2010 INDUSTRIAL PARK RD, ESPANOLA, NM 87532-3600
(505) 753-7395
(505) 426-3492
Mailing address
1331 GUSDORF RD, TAOS, NM 87571-6282
(505) 753-7218
(505) 747-7396
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
PA2019-0101
NM
Other
Enumeration date
11/06/2019
Last updated
11/07/2019
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