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Organization

PHC LAS CRUCES INC

Active
Other names
ID Consultants
Organization subpart
No

Provider details

NPI number
Authorized official
ANGIE MANGUM (DIRECTOR)
(575) 521-5277
Entity
Organization

Contact information

Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
(575) 521-5277
Mailing address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
(575) 521-5277

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary

Other

Enumeration date
08/31/2011
Last updated
08/31/2011
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