Individual
KRYSTAL BORTCOSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4311 E LOHMAN AVE, LAS CRUCES, NM 88011-8255
(575) 556-7600
Mailing address
4311 E LOHMAN AVE, LAS CRUCES, NM 88011-8255
(575) 556-7785
(575) 556-7789
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
297570
NY
207R00000X
Internal Medicine Physician
Primary
DO2022-0109
NM
207R00000X
Internal Medicine Physician
DO2022-109
NM
Other
Enumeration date
05/10/2016
Last updated
10/24/2023
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