Individual
MR. KEVIN WHATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
TECHNICIAN
Contact information
Practice address
2516 GRETTA ST NE, ALBUQUERQUE, NM 87112-1627
(505) 480-9126
Mailing address
2516 GRETTA ST NE, ALBUQUERQUE, NM 87112-1627
(505) 480-9126
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
NM
Other
Enumeration date
09/18/2009
Last updated
04/25/2016
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