DE BACA FAMILY PRACTICE CLINIC

NPI # 

Practice Address:

1001 Sumner Ave

Fort Sumner, NM, 88119-0349

Practice Phone:

575-355-4431

Practice Fax:

575-355-4432

License Number:

3069

License State:

NM

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Federally Qualified Health Center (FQHC)

Taxonomy Code:

261QF0400X