Individual
BRIAN T MUNIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
117 CAMINO DE VIDA STE 300, SANTA ROSA, NM 88435-2267
(575) 472-4311
(575) 472-4313
Mailing address
117 CAMINO DE VIDA STE 300, SANTA ROSA, NM 88435-2267
(575) 472-4311
(575) 472-4313
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2017-0082
NM
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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