Individual
CAROL S CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1501 SAN PEDRO SE, ALBUQUERQUE, NM 87108
(505) 265-1711
Mailing address
PO BOX 229, PERALTA, NM 87042-0229
(505) 866-1731
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
95-PA03
NM
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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