Individual
EDMUND MCNALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
301 S LAKE ST, FARMINGTON, NM 87401-5619
(505) 278-8575
(505) 787-2399
Mailing address
301 S LAKE ST, FARMINGTON, NM 87401-5619
(505) 278-8575
(505) 787-2399
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
91-PA04
NM
Other
Enumeration date
06/02/2009
Last updated
12/04/2024
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