Individual
MICHAEL MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5141
(755) 228-6415
Mailing address
2942 JOHNSON ST, LAS CRUCES, NM 88005-1288
(575) 312-1039
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86030921
IL
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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