Kewa Pueblo Health Corporation

NPI #1902183155 in Santo Domingo, New Mexico

Provider Information

NPI Number
1902183155
Entity Type
Organization
Organization Name
Kewa Pueblo Health Corporation
Subpart
Yes (part of a larger organization)
Parent Organization
KEWA PUEBLO HEALTH CORPORATION
Primary Specialty
Clinic/Center - Hearing and Speech
Enumeration Date
Nov 15, 2011
Last Updated
Nov 15, 2011

Practice Location

Address
85 W HIGHWAY 22
ZIP Code
87052-0340
Phone
(505) 465-3060

Authorized Official

Name
VANESSA DIANA VIGIL
Title
BUSINESS OFFICE MANAGER
Phone
(505) 465-3060

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Hearing and SpeechHearing and Speech

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