Individual
MRS. SADIE M. BENALLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
07 CHOOSGAI DRIVE, TOHATCHI, NM 87325
(505) 733-8150
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 733-8150
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L04547
NM
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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