Individual
RUBEN COSTALES NANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MT ASCP
Contact information
Practice address
661 WENDY LN, LAS CRUCES, NM 88007-5324
(575) 649-1847
Mailing address
661 WENDY LN, LAS CRUCES, NM 88007-5324
(575) 649-1847
Taxonomy
Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
Primary
MT175482
NM
Other
Enumeration date
02/09/2020
Last updated
02/09/2020
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