Individual
SHANE BENALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
85 W HIGHWAY 22, SANTO DOMINGO PUEBLO, NM 87052-1283
(505) 465-1169
Mailing address
5300 LAS SOLERAS DR APT 6003, SANTA FE, NM 87507-2002
(901) 653-5701
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100585
ID
Other
Enumeration date
09/19/2022
Last updated
07/22/2025
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