Individual
MR. GREGORY THOMAS LYLES-DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
332 JEFFERSON ST NE, APT A, ALBUQUERQUE, NM 87108-1259
(505) 212-7405
Mailing address
332 JEFFERSON ST NE, APT A, ALBUQUERQUE, NM 87108-1259
(505) 212-7405
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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