Organization
KEWA PUEBLO HEALTH CORPORATION
Active
Parent organization
KEWA PUEBLO HEALTH CORPORATION
Other names
Santo Domingo Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
KEWA PUEBLO HEALTH CORPORATION
Authorized official
VANESSA DIANA VIGIL (BUSINESS OFFICE MANAGER)
(505) 465-3060
Entity
Organization
Contact information
Practice address
85 W HIGHWAY 22, SANTO DOMINGO, NM 87052-0340
(505) 465-3060
(505) 465-1191
Mailing address
PO BOX 559, SANTO DOMINGO PUEBLO, NM 87052-0559
(505) 465-3060
(505) 465-1191
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
11/15/2011
Last updated
11/15/2011
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