Organization
ESTETICA DE ELLA SALON (CRANIAL PROSTHESIS)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAVIER TORRES (PRESIDENT/OWNER)
(505) 830-3333
Entity
Organization
Contact information
Practice address
2510 SAN MATEO PL NE, ALBUQUERQUE, NM 87110-4064
(505) 830-3333
(505) 881-2857
Mailing address
2510 SAN MATEO PL NE, ALBUQUERQUE, NM 87110-4064
(505) 830-3333
(505) 881-2857
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
FA0026088
NM
Other
Enumeration date
09/27/2010
Last updated
09/29/2010
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