Individual
MS. SUSAN ERNESTINE VIGIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
HWY 518 MM 26, MORA, NM 87732-0209
(575) 387-2481
Mailing address
PO BOX 209, MORA, NM 87732-0209
(575) 387-2481
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
3936
NM
Other
Enumeration date
09/22/2009
Last updated
09/23/2009
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