Organization
PRESBYTERIAN EAR INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM JOHNSON (OFFICE MANAGER)
(505) 224-7020
Entity
Organization
Contact information
Practice address
415 CEDAR STREET SE, ALBUQUERQUE, NM 87106-3927
(505) 224-7020
(505) 224-7023
Mailing address
415 CEDAR STREET SE, ALBUQUERQUE, NM 87106-3927
(505) 224-7020
(505) 224-7023
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50757
—
NM
05
—
B0662
—
NM
Enumeration date
10/20/2006
Last updated
10/17/2017
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