Organization
ACTION-OCCMED-M.M.I., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN LEE KENNEDY M.D. (PRESIDENT)
(575) 556-1011
Entity
Organization
Contact information
Practice address
530 N TELSHOR BLVD, SUITE B, LAS CRUCES, NM 88011-8243
(575) 556-1011
(575) 532-9581
Mailing address
530 N TELSHOR BLVD, SUITE B, LAS CRUCES, NM 88011-8243
(575) 556-1011
(575) 532-9581
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
87-184
NM
261QX0100X
Occupational Medicine Clinic/Center
87-104
NM
Other
Enumeration date
10/28/2007
Last updated
10/28/2007
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