Individual
PHILIP ANDREW RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
5901 ZUNI RD SE, ALBUQUERQUE, NM 87108-3073
(505) 841-8978
(505) 841-8974
Mailing address
6008 NORTHLAND AVE NE, ALBUQUERQUE, NM 87109-2643
(505) 837-1655
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L10572
NM
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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