Individual
URIAH SIMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1615 OJO COURT, FARMINGTON, NM 87401-0001
(505) 564-4804
Mailing address
PO BOX 5190, FARMINGTON, NM 87499-5190
(505) 564-4804
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
115889273
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115889273
NEW MEXICO DRIVER'S LICENSE
NM
Enumeration date
10/12/2015
Last updated
10/12/2015
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