Individual
MR. KEVIN MCCORMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LBSW
Contact information
Practice address
9 E CHALLENGER ST, ROSWELL, NM 88203-8461
(575) 347-2409
Mailing address
9 E CHALLENGER ST, ROSWELL, NM 88203-8461
(575) 347-2409
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
B-3720
NM
Other
Enumeration date
05/15/2014
Last updated
05/15/2014
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