Individual
MARY LOU CHUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
6143 FULL MOON AVE NW, ALBUQUERQUE, NM 87114-4065
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R37136
NM
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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