Individual
JOSE ANGEL RIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
60 RANGE RD, EDGEWOOD, NM 87015-9028
(505) 620-6676
Mailing address
60 RANGE RD, EDGEWOOD, NM 87015-9028
(505) 620-6676
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
511309484
NM
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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