Organization
CLOVIS FAMILY HEALTHCARE CENTER LLC
Active
Other names
Encore Express Care
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA SHRADER (OWNER)
(575) 762-4455
Entity
Organization
Contact information
Practice address
2301 N MLK BLVD, CLOVIS, NM 88101-9401
(505) 762-4455
(505) 763-4029
Mailing address
2301 N MLK BLVD, CLOVIS, NM 88101-9401
(505) 762-4455
(505) 763-4029
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A112299
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
62706501
—
NM
Enumeration date
12/12/2006
Last updated
01/27/2021
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