Organization
SAN JUAN MINERS' ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL LORETT (MEMBER)
(505) 819-8501
Entity
Organization
Contact information
Practice address
2012 SAN JUAN BLVD # B, FARMINGTON, NM 87401-2220
(505) 819-8501
Mailing address
2012 SAN JUAN BLVD # B, FARMINGTON, NM 87401-2220
(505) 402-4067
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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