Individual
DONAVAN ARCHULETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4600 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1210
(505) 369-1275
Mailing address
6804 PAESE PL NW, ALBUQUERQUE, NM 87114-5193
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/26/2025
Last updated
06/26/2025
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