Whalio Doctors

NPI 1972948297

Lyric Jackson

Practitioner Driver Rio Rancho, NM

Practice location

Address
3513 Plano Vista NE, Rio Rancho, NM 87124
Phone
(505) 433-7039
Mailing address
3513 Plano Vista Rd NE, Rio Rancho, NM 87124-4183

Registered specialties

Driver Primary
Other Service Providers Taxonomy 172A00000X Licence 107737260 (NM)

Registry record

NPI
1972948297
Entity type
Individual
Sex (as registered)
Male
NPI issued
30 Apr 2013
Record last updated
30 Apr 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.