Individual
KAITLYN THERESE ARCHIBEQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1370A HWY 313, ALGODONES, NM 87001
(505) 414-4565
Mailing address
P.O. BOX 716, ALGODONES, NM 87001
(505) 414-4565
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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