Organization
ROBERTA L. FENNIG DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERTA LEE FENNIG DO (PRESIDENT)
(915) 494-1237
Entity
Organization
Contact information
Practice address
5305 MCNUTT RD, SUITE H, SANTA TERESA, NM 88008-9685
(575) 589-1770
(575) 589-1799
Mailing address
PO BOX 4, SANTA TERESA, NM 88008-0004
(575) 589-1770
(575) 589-1799
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A167712
NM
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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