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Individual

RYAN STURGES BOZZELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
735 W ANIMAS ST, FARMINGTON, NM 87401-5616
(505) 609-6300
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
54843
NM

Other

Enumeration date
12/28/2018
Last updated
11/14/2024
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