Organization
THE SPORTS MEDICINE CLINIC
Active
Organization
THE SPORTS MEDICINE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA PEIPER (OPERATIONS DIRECTOR)
(505) 377-5733
Entity
Organization
Contact information
Practice address
2469 CORRALES RD, SUITE A2, CORRALES, NM 87048-9146
(505) 377-5733
Mailing address
2469 CORRALES RD, SUITE A2, CORRALES, NM 87048-9146
(505) 377-5733
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
FA0102165
NM
Other
Enumeration date
11/19/2015
Last updated
11/19/2015
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