Organization
UNM CDD - MI VIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN GALLEGOS (ADMINISTRATIVE SUPPORT SUPERVISOR)
(505) 272-6251
Entity
Organization
Contact information
Practice address
2300 MENAUL BLVD NE, ALBUQUERQUE, NM 87107-1851
(505) 272-6251
Mailing address
2300 MENAUL BLVD NE, ALBUQUERQUE, NM 87107-1851
(505) 272-6251
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
91-90
NM
Other
Enumeration date
12/04/2012
Last updated
12/04/2012
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