Organization
GILA EYECARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS M. MITTICA JR. M.D. (PHYSICIAN/OWNER)
(575) 388-4464
Entity
Organization
Contact information
Practice address
604 W SPRING ST, SILVER CITY, NM 88061-4847
(575) 388-4464
(575) 388-2014
Mailing address
604 W SPRING ST, SILVER CITY, NM 88061-4847
(575) 388-4464
(575) 388-2014
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27502562
—
NM
Enumeration date
05/12/2006
Last updated
04/17/2014
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