Individual
MONICA ANNETTE DAVALOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2810 SUDDERTH DR STE A, RUIDOSO, NM 88345-6348
(423) 490-5750
Mailing address
PO BOX 807, TULAROSA, NM 88352-0807
(423) 490-5750
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PM22006
NM
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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