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Organization

JUAN N SOSA PHD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JUAN N SOSA PHD (OWNER)
(575) 522-8002
Entity
Organization

Contact information

Practice address
1155 S TELSHOR BLVD, SUITE 200, LAS CRUCES, NM 88011-1009
(575) 522-8002
(575) 522-8027
Mailing address
1155 S TELSHOR BLVD, SUITE 200, LAS CRUCES, NM 88011-1009
(575) 522-8002
(575) 522-8027

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
163
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
N5806
NM
Enumeration date
08/17/2012
Last updated
08/17/2012
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