Individual
JENYCE BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
346 EAGLE DR, OHKAY OWINGEH, NM 87566-3600
(505) 852-1377
Mailing address
346 EAGLE DR, OHKAY OWINGEH, NM 87566-3600
(505) 852-1377
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NM
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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