Organization
OCCUPATIONAL MEDICINE 360
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATY LOUISE WAMEL-PETERMEIER (OWNER)
(575) 496-5551
Entity
Organization
Contact information
Practice address
2525 S. TELSHOR BLVD BLDG. 16 STE.106, LAS CRUCES, NM 88011
(575) 496-5551
Mailing address
2525 S. TELSHOR BLVD BLDG. 16 STE.106, LAS CRUCES, NM 88011
(575) 496-5551
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
03239181001
NM
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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