Individual
MRS. LEISHATT TORREBLANCA VILLENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
313 W COUNTRY CLUB RD, SUITE 13, ROSWELL, NM 88201-5804
(575) 625-1371
Mailing address
906 MULLIS ST, ROSWELL, NM 88201-1154
(305) 989-0103
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD2012-0759
NM
Other
Enumeration date
09/10/2013
Last updated
09/10/2013
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