Santa Fe Family and Functional Medicine PC
NPI #1255400040 in Santa Fe, New Mexico
Provider Information
- NPI Number
- 1255400040
- Entity Type
- Organization
- Organization Name
- Santa Fe Family and Functional Medicine PC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Nov 7, 2006
- Last Updated
- Jul 13, 2017
Practice Location
- Address
- 401 BOTULPH LANE
- City
- Santa Fe
- State
- New Mexico
- ZIP Code
- 87505
- Phone
- (505) 983-8387
Authorized Official
- Name
- BRUCE E GOLLUB, MD
- Title
- PRESIDENT
- Phone
- (505) 983-8387
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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