Individual
JAVIER CORNEJO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPSW
Contact information
Practice address
530 N TELSHOR BLVD STE C, LAS CRUCES, NM 88011-8243
(575) 215-3389
Mailing address
816 LIVESAY STREET, POBOX 1482, ANTHONY, NM 88021
(915) 352-8932
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1565
NM
Other
Enumeration date
06/27/2025
Last updated
07/01/2025
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