| Over the Edge | |
|
7010 Phoenix Ave Ne Apt 310 Albuquerque NM 87110-3505 | |
| (505) 508-5708 | |
| Not Available |
| Full Name | Over the Edge |
|---|---|
| Speciality | Clinic/center |
| Location | 7010 Phoenix Ave Ne Apt 310, Albuquerque, New Mexico |
| Authorized Official Name and Position | Autrell Sherrod Brown (OWNER/CEO) |
| Authorized Official Contact | 5054636328 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Over the Edge 7010 Phoenix Ave Ne Apt 310 Albuquerque NM 87110-3505 Ph: (505) 508-5708 | Over the Edge 7010 Phoenix Ave Ne Apt 310 Albuquerque NM 87110-3505 Ph: (505) 508-5708 |
| NPI Number | 1598058232 |
|---|---|
| Provider Enumeration Date | 05/26/2011 |
| Last Update Date | 05/26/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598058232 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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