Individual
JOSEPH ACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
618 MANZANO ST NE, ALBUQUERQUE, NM 87110-6302
(505) 925-4353
Mailing address
501 MINDORO DR SE, RIO RANCHO, NM 87124-4316
(575) 202-4830
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
171M00000X
NM
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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