Individual
SPENCER WILLIAM HALVORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2300 E 30TH ST STE 101, FARMINGTON, NM 87401-8990
(505) 208-6280
Mailing address
2300 E 30TH ST STE 101, FARMINGTON, NM 87401-8990
(505) 208-6280
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2024-0070
NM
Other
Enumeration date
06/28/2024
Last updated
06/28/2024
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