Individual
JEREMY JOHNNY SALAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
21230 HWY 84, ABIQUIU, NM 87510
(505) 927-9890
Mailing address
PO BOX 1123, ABIQUIU, NM 87510-1123
(505) 927-9890
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
08/25/2016
Last updated
08/25/2016
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