Provider Demographics
NPI:1467707471
Name:HELFRICH, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:HELFRICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 PASEO DEL MONTE
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-6320
Mailing Address - Country:US
Mailing Address - Phone:505-983-2456
Mailing Address - Fax:505-983-2456
Practice Address - Street 1:2101 PASEO DEL MONTE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-6320
Practice Address - Country:US
Practice Address - Phone:505-983-2456
Practice Address - Fax:505-983-2456
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM32466171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor