Organization
ACADEMY ORTHOPAEDIC CLINIC LLC
Active
Other names
Thomas Grace, MD
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FRIEDA WRIGHT (OFFICE MANAGER)
(505) 821-6663
Entity
Organization
Contact information
Practice address
8301 SPAIN RD NE, ALBUQUERQUE, NM 87109-3166
(505) 821-6663
(505) 823-2683
Mailing address
8301 SPAIN RD NE, ALBUQUERQUE, NM 87109-3166
(505) 821-6663
(505) 823-2683
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
77-38
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000F0316
—
NM
01
—
NM007588
BC/BS OF NM
NM
Enumeration date
09/13/2007
Last updated
12/10/2007
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