Individual
DANIEL CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
20 BLUEBIRD RD., PLACITAS, NM 87043-8835
(505) 980-0027
(505) 867-1392
Mailing address
20 BLUEBIRD RD., PLACITAS, NM 87043-8835
(505) 980-0027
(505) 867-1392
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1785
NM
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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