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Individual

DR. MAVRICK JAMES LOBE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DOM

Contact information

Practice address
1348 PACHECO ST, SUITE 103, SANTA FE, NM 87505-4222
(505) 577-1588
Mailing address
1348 PACHECO ST, SUITE 103, SANTA FE, NM 87505-4222
(505) 577-1588

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
446RX2
NM
208D00000X
General Practice Physician
Primary
446RX2
NM
208VP0014X
Interventional Pain Medicine Physician
446RX2
NM

Other

Enumeration date
04/09/2009
Last updated
05/11/2009
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