Organization
ANGEL FIRE PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESA D FRAKER M.D. (PRESIDENT)
(505) 989-8707
Entity
Organization
Contact information
Practice address
37 ASPEN, ANGEL FIRE, NM 87710-0000
(575) 377-1805
Mailing address
707 PASEO DE PERALTA, SANTA FE, NM 87501-1922
(505) 989-8707
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NM
Other
Enumeration date
12/07/2011
Last updated
05/15/2012
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