Individual
SALLY VANCUREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
COUNTY ROAD 75, HOUSE #285, TRUCHAS, NM 87578
(505) 927-3497
Mailing address
PO BOX 1024, SANTA CRUZ, NM 87567-1024
(505) 927-3497
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
NM
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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