Organization
MADDOG MECHANICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD R FINLEY (PARTNER)
(505) 550-0335
Entity
Organization
Contact information
Practice address
2125 LOS LENTES RD NE, LOS LUNAS, NM 87031-6532
(505) 550-0335
Mailing address
2125 LOS LENTES RD NE, LOS LUNAS, NM 87031-6532
(505) 550-0335
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
356742
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01277203
AMERIGROUP
NM
Enumeration date
12/01/2009
Last updated
12/01/2009
Update your record
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