Organization
INEZ M BEAUPRE LEWIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INEZ M BEAUPRE LEWIS (OWNER)
(505) 864-1842
Entity
Organization
Contact information
Practice address
88 EDMUNDO RD, BELEN, NM 87002-7700
(505) 864-1842
Mailing address
88 EDMUNDO RD, BELEN, NM 87002-7700
(505) 864-1842
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000T4331
—
NM
Enumeration date
12/28/2007
Last updated
11/22/2010
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