Individual
DOLORES ANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
255 HIGHWAY 187, HATCH, NM 87937-0370
(575) 267-3088
(575) 267-4565
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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