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General NPI Number Information
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NPI Number | 1598874794
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Entity Type | Organization
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Legal Business Name | ALTO MEDICAL SERVICES, PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2110 S MAIN STREET
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City | ROSWELL
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State | NM
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Zip | 88203
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Country | US
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Telephone | 505-622-4328
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Fax | 505-624-2862
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Provider Business Mailing Address
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Address Line | 2110 S MAIN STREET
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City | ROSWELL
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State | NM
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Zip | 88203
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Country | US
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Telephone | 505-622-4328
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Fax | 505-624-2862
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | NORELLA HANNIGAN
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Credential |
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Telephone | 505-622-4320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 80-44
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License Number State | NM
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