Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 82160 | NM |
NPI | 1245311034 |
---|---|
Provider Name | Teresa V Balcomb |
First Address | Albuquerque, NM 87125 |
Second Address | Albuquerque, NM 87108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 20/09/2011 |