Bethphage Mission West
NPI #1649482639 in Grants, New Mexico
Provider Information
- NPI Number
- 1649482639
- Entity Type
- Organization
- Organization Name
- Bethphage Mission West
- Primary Specialty
- Specialist
- Enumeration Date
- May 4, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 920 LOBO CANYON RD
- Address 2
- SUITE 5A
- City
- Grants
- State
- New Mexico
- ZIP Code
- 87020-2173
- Phone
- (505) 287-9333
Authorized Official
- Name
- DEAN WILSON
- Title
- VP ACCOUNTING
- Phone
- (402) 896-3884
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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