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Organization

WESTERN STATES C.C.T. INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GREG MATTHEW HESCH FPC (VICE PRESIDENT OF MEDICAL OPERATION)
(505) 660-7719
Entity
Organization

Contact information

Practice address
424 HARRIS RD, LAS VEGAS, NM 87701-4840
(505) 454-3847
(505) 454-3852
Mailing address
424 HARRIS RD., LAS VEGAS, NM 87508
(505) 454-3847
(505) 454-3852

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
06416
NM

Other

Enumeration date
07/18/2012
Last updated
07/18/2012
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