| Roberta L. Fennig Do Pc | |
|
5305 Mcnutt Rd Suite H Santa Teresa NM 88008-9685 | |
| (575) 589-1770 | |
| (575) 589-1799 |
| Full Name | Roberta L. Fennig Do Pc |
|---|---|
| Speciality | Clinic/center |
| Location | 5305 Mcnutt Rd, Santa Teresa, New Mexico |
| Authorized Official Name and Position | Roberta Lee Fennig (PRESIDENT) |
| Authorized Official Contact | 9154941237 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roberta L. Fennig Do Pc Po Box 4 Santa Teresa NM 88008-0004 Ph: (575) 589-1770 | Roberta L. Fennig Do Pc 5305 Mcnutt Rd Suite H Santa Teresa NM 88008-9685 Ph: (575) 589-1770 |
| NPI Number | 1912259441 |
|---|---|
| Provider Enumeration Date | 10/08/2012 |
| Last Update Date | 10/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912259441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | A167712 (New Mexico) | Primary |
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