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SHANE NEWSOM, 390200000X

390200000X

Contractor

NPI: 1578184990Individual

Specialties, Licenses & Credentials

ContractorPrimary

Contractor

Code: 171W00000X

Contact & Hours

Address
12300 MODESTO AVE NE
ALBUQUERQUE, NM 87122

Quick Facts

NPI
1578184990
Entity Type
Individual
Gender
Male
Medicare
Not confirmed
Specialties
1
Locations
1

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