Individual
AMANDO RIVARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1414 UNIVERSITY BLVD. SE, ALBUQUERQUE, NM 87106
(505) 550-1293
Mailing address
5601 TAYLOR RANCH RD NW APT 313, ALBUQUERQUE, NM 87120-2663
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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