Individual
AUSTIN LYN MOEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1414 NARCISCO ST NE, ALBUQUERQUE, NM 87112-6536
(505) 293-3767
(505) 293-1969
Mailing address
1414 NARCISCO ST NE, ALBUQUERQUE, NM 87112-6536
(505) 293-3767
(505) 293-1969
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
96-105
NM
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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