Individual
BARTHOLOMEW J LALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
933 SAN MATEO BLVD NE STE 500, ALBUQUERQUE, NM 87108-1862
(505) 204-5150
(505) 494-1056
Mailing address
933 SAN MATEO NE SUITE 500 #174, ALBUQUERQUE, NM 87108
(505) 204-5150
(505) 494-1056
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2016-0077
NM
Other
Enumeration date
09/13/2016
Last updated
11/10/2020
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