Individual
ANTHONY CORNEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1217 1ST ST NW, ALBUQUERQUE, NM 87102-1529
(505) 766-5197
Mailing address
11059 E BETHANY DR, AURORA, CO 80014-2622
(303) 617-2300
(303) 617-2365
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
092370245
CO
Other
Enumeration date
01/28/2015
Last updated
04/27/2022
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