Individual
MICHAEL QUINTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
614 8TH ST, LAS VEGAS, NM 87701-4251
(505) 425-3644
(505) 454-0787
Mailing address
614 8TH ST, LAS VEGAS, NM 87701-4251
(505) 425-3644
(505) 454-0787
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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