Individual
MARCO ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
46 MONICA RD, PERALTA, NM 87042-5171
(505) 681-1530
Mailing address
46 MONICA RD, PERALTA, NM 87042-5171
(505) 681-1530
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
08/26/2016
Last updated
08/26/2016
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