Individual
ANDREW GALLEGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
237 SERVICE RD, RUIDOSO, NM 88345-6063
(575) 257-2368
(575) 257-2141
Mailing address
237 SERVICE RD, RUIDOSO, NM 88345-6063
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
5402
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
850441031
—
NM
Enumeration date
12/18/2013
Last updated
12/18/2013
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