Individual
MARK ALLEN LIMBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
622 W MAPLE ST, SUITE B, FARMINGTON, NM 87401-6590
(505) 327-4867
(505) 327-5355
Mailing address
622 W MAPLE ST, SUITE B, FARMINGTON, NM 87401-6590
(505) 327-4867
(505) 327-5355
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
94-PA29
NM
Other
Enumeration date
07/13/2006
Last updated
03/07/2008
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