Individual
LAWANDA T JIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
US HWY 491 N, SHIPROCK, NM 87420
(505) 368-6001
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2012-0721
NM
Other
Enumeration date
05/27/2008
Last updated
02/13/2013
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