Organization
SAN MIGUEL CLINIC CORP
Active
Organization
SAN MIGUEL CLINIC CORP
Active
Other names
LV Medical Group- Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES P WRIGHT (SR. DIRECTOR)
(615) 465-7587
Entity
Organization
Contact information
Practice address
2515 RIDGE RUNNER RD, LAS VEGAS, NM 87701-4972
(505) 454-0322
(505) 425-6410
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(888) 422-1522
(615) 628-6984
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/22/2015
Last updated
08/20/2015
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