Organization
AGNES MARTINEZ FAMILY HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY BUNKER CNP (OWNER)
(505) 387-5503
Entity
Organization
Contact information
Practice address
STATE HIGHWAY 518 MILE MARKER 29, MORA, NM 87732-0185
(505) 387-5503
(505) 387-5502
Mailing address
PO BOX 185, MORA, NM 87732-0185
(505) 387-5503
(505) 387-5502
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
363LF0000X
NM
Other
Enumeration date
12/19/2007
Last updated
12/19/2007
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