Individual
JORDYN AHLGRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3415 N BUENA VISTA AVE, FARMINGTON, NM 87401-2309
(505) 635-6301
Mailing address
3415 N BUENA VISTA AVE, FARMINGTON, NM 87401-2309
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
10/22/2017
Last updated
10/22/2017
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