Healthcare Provider Details

I. General information

NPI: 1952215170
Provider Name (Legal Business Name): CHRISTOPHER MUNIZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 W FREEDOM WAY
BLANDING UT
84511-3216
US

IV. Provider business mailing address

4615 SUMMER WIND
FARMINGTON NM
87401-4424
US

V. Phone/Fax

Practice location:
  • Phone: 505-430-9554
  • Fax:
Mailing address:
  • Phone: 505-430-9554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberAZ00019959
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: