Organization
LC-ENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY H MCMILLAN (OWNER)
(575) 521-3025
Entity
Organization
Contact information
Practice address
1130 COMMERCE DR, LAS CRUCES, NM 88011-8209
(575) 521-3025
Mailing address
1130 COMMERCE DR, LAS CRUCES, NM 88011-8209
(575) 521-3025
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
2470
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
U8766
—
NM
Enumeration date
01/22/2007
Last updated
05/14/2013
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