Organization
SOUTHWEST CENTER FOR INTEGRATIVE MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIC STAPE D.O.M. (C.E.O./ OWNER)
(505) 298-4325
Entity
Organization
Contact information
Practice address
1012 EUBANK BLVD NE, ALBUQUERQUE, NM 87112-5310
(505) 298-4325
(505) 294-5407
Mailing address
1012 EUBANK BLVD NE, ALBUQUERQUE, NM 87112-5310
(505) 298-4325
(505) 294-5407
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
BB7316436
NM
Other
Enumeration date
01/23/2012
Last updated
05/10/2012
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