Organization
EAST MOUNTAIN EYE CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRIA DULCE WALKER O.D. (PRESIDENT)
(505) 286-2020
Entity
Organization
Contact information
Practice address
1917 OLD ROUTE 66, EDGEWOOD PLAZA, SUITE D-1, EDGEWOOD, NM 87015
(505) 286-2020
(505) 286-2244
Mailing address
PO BOX 400, EDGEWOOD, NM 87015-0400
(505) 286-2020
(505) 286-2244
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NM425
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P1928
—
NM
Enumeration date
10/21/2005
Last updated
10/06/2008
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