Organization
MESA OCCUPATIONAL & SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY FREDERICK MOSLEY (CONTRACT MANAGER)
(505) 325-1100
Entity
Organization
Contact information
Practice address
2700 FARMINGTON AVE, BUILDING F AND G, FARMINGTON, NM 87401-4559
(505) 325-1100
Mailing address
2700 FARMINGTON AVE, BUILDING F AND G, FARMINGTON, NM 87401-4559
(505) 325-1100
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
09/22/2006
Last updated
08/22/2020
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