Legacy Family Medicine LLC
NPI #1265172399 in Gallup, New Mexico
Provider Information
- NPI Number
- 1265172399
- Entity Type
- Organization
- Organization Name
- Legacy Family Medicine LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Mar 29, 2022
- Last Updated
- Mar 29, 2022
Practice Location
- Address
- 1808 E AZTEC AVE STE 6
- City
- Gallup
- State
- New Mexico
- ZIP Code
- 87301-4946
- Phone
- (505) 863-9374
Authorized Official
- Name
- BRETT HARTLINE
- Title
- ADMINISTRATOR
- Phone
- (480) 498-9086
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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