Most Relevant Information
Provider Data
| NPI Number: | 1003326661 |
| Provider Name: | MANUEL ENRIQUE VALENZUELA COTA/L |
| Entity Type: | Individual |
| Taxonomy Code: | 171W00000X |
| Specialty: | Contractor |
| License Number: | 3814 |
Most Important Dates
| Enumeration Date: | 10/09/2017 |
| Last Updated: | 10/09/2017 |
Provider Practice Location
8016 PETROGLYPH AVE NW
ALBUQUERQUE
NM
871206558
Practice Location Phone/Fax
| Phone: | 5052285050 |
| Fax: |
Provider Mailing Location
1333 BONITO RD SW
ALBUQUERQUE
NM
871054606
Provider Mailing Phone/Fax
| Phone: | 5055159333 |
| Fax: |