Rustic Health Diagnostics LLC
NPI #1669288874 in T Or C, New Mexico
Provider Information
- NPI Number
- 1669288874
- Entity Type
- Organization
- Organization Name
- Rustic Health Diagnostics LLC
- Primary Specialty
- Clinical Medical Laboratory
- Enumeration Date
- Dec 4, 2024
- Last Updated
- Dec 4, 2024
Practice Location
- Address
- 405 N DATE ST STE 4
- City
- T Or C
- State
- New Mexico
- ZIP Code
- 87901-2378
- Phone
- (575) 297-4993
Authorized Official
- Name
- DAVID JOHN DONAVAN, LPN
- Title
- OWNER
- Phone
- (575) 297-4993
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinical Medical Laboratory |
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