SMALL TOWN FAMILY PRACTICE LLC NPI 1164194940

NPI Information

SMALL TOWN FAMILY PRACTICE LLC is a primary care clinic center in Albuquerque, NM. SMALL TOWN FAMILY PRACTICE LLC NPI is 1164194940. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4225 MONTGOMERY BLVD NE
ALBUQUERQUE, NM
ZIP 87109-103
Phone: (505) 366-3635
Fax: (505) 221-5429

The provider's authorized official is Deanna Rene Clark .
The authorized official title is Co-owner/ Co-manager and has the following contact phone number (505) 366-3635.

The enumeration date for this NPI number is 9/30/2021 and was last updated on 9/30/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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