Individual
JEREMY STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
1581 CORTA CANCUN, LOS LUNAS, NM 87031-8747
(915) 433-3922
Mailing address
1581 CORTA CANCUN, LOS LUNAS, NM 87031-8747
(915) 433-3922
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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