Provider Type: Ambulatory Health Care Facilities
Provider Classification: Clinic/Center
Provider Specialization: Medical Specialty
Definition of Specialization:
Address: 4 Calle Medico
C
Santa Fe, NM 87505-4791
Phone: (610) 952-4418
Fax: (610) 369-2710
Authorized Official: Dr. Mickle, James D., Jr., MD
Authorized Official Position: Sole Proprietor
Authorized Official Phone: (610) 952-4418


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