Individual
MARIO MADRID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
413 SIPAPU ST, TAOS, NM 87571-6489
(575) 758-5857
(575) 758-5860
Mailing address
413 SIPAPU ST, TAOS, NM 87571-6489
(575) 758-5857
(575) 758-5860
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/28/2011
Last updated
12/28/2011
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