Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | LMT2668 | NM |
NPI | 1518163625 |
---|---|
Provider Name | Sandra K Kitchens |
First Address | Clovis, NM 88101-3552 |
Second Address | Clovis, NM 88101-3843 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 08/07/2007 |