Four Corners LLC

NPI #1700362738 in Santa Fe, New Mexico

Provider Information

NPI Number: 1700362738
Entity Type: Organization
Organization Name: Four Corners LLC
Primary Specialty: Driver
Enumeration Date: Jul 12, 2018
Last Updated: Jul 12, 2018

Practice Location

Address: 1704 LLANO ST STE B
City: Santa Fe
State: New Mexico
ZIP Code: 87505-5415
Phone: (520) 339-9276

Authorized Official

Name: MR. OSAMA WALI
Title: GENERAL MANAGER
Phone: (520) 339-9726

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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