Organization
SPINE & PAIN INSTITUTE OF SANTA FE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THERESA M GENOVESE ELLIOTT MD (OWNER)
(505) 983-5200
Entity
Organization
Contact information
Practice address
435 ST. MICHAEL'S DRIVE, SUITE A-202, SANTA FE, NM 87505-7672
(505) 983-5200
(505) 983-5202
Mailing address
P O BOX 6140, SANTE FE, NM 87502-6140
(505) 983-5200
(505) 983-5202
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2001169
NM
Other
Enumeration date
05/27/2006
Last updated
06/09/2009
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