Individual
WILLIAM J BACA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPSW
Contact information
Practice address
320 OSUNA RD NE STE H4, ALBUQUERQUE, NM 87107-5955
(505) 345-2778
(505) 345-2878
Mailing address
5823 AVENIDA LA BARRANCA NW, ALBUQUERQUE, NM 87114-4823
(505) 261-1617
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1344
NM
Other
Enumeration date
04/26/2022
Last updated
04/26/2022
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