Organization
LIVEWELL BUILDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD EDGAR GLOETZNER GB-98 (OWNER)
(505) 281-9109
Entity
Organization
Contact information
Practice address
30 SHADE TREE LN, TIJERAS, NM 87059-7637
(505) 281-9109
Mailing address
30 SHADE TREE LN, TIJERAS, NM 87059-7637
(505) 281-9109
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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