Individual
MR. LEANDER NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2025 E AZTEC AVE, GALLUP, NM 87301-4803
(505) 863-3828
Mailing address
2025 E AZTEC AVE, GALLUP, NM 87301-4803
(505) 863-3828
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Enumeration date
04/26/2019
Last updated
04/29/2019
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