Individual
MR. CORY JAMES CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1090 GOAT SPRINGS RD, TAOS, NM 87571
(505) 758-4224
(505) 751-5211
Mailing address
PO BOX 1946, TAOS PLAINS INDIAN HEALTH CENTER, TAOS, NM 87571
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
CAVN228748
CA
Other
Enumeration date
01/31/2008
Last updated
05/01/2008
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