Individual
JIMMY GARCIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
UCC OFFICER
Contact information
Practice address
130 N 2ND ST, RATON, NM 87740-3804
(575) 445-3557
Mailing address
PO BOX 28220, SANTA FE, NM 87592-8220
(505) 471-5006
(505) 820-9220
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/09/2009
Last updated
09/09/2009
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