Individual
MR. WILLIAM FRESQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
508 STATE HWY 518, HELPING HANDS INC, MORA, NM 87732-0708
(575) 387-2288
Mailing address
HWY 121 #595, P.O. BOX 72, CHACON, NM 87713-0072
(575) 387-2764
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3718
NM
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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