Individual
JASON J INNERHOFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA(ASCP)
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 841-1591
Mailing address
8820 MANCOS ST NW, ALBUQUERQUE, NM 87114-6459
(505) 841-1591
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
NM
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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