Primary Wellness Team Corporation
NPI #1417489378 in Santa Teresa, New Mexico
Provider Information
- NPI Number
- 1417489378
- Entity Type
- Organization
- Organization Name
- Primary Wellness Team Corporation
- Primary Specialty
- Psychologist - Prescribing (Medical)
- Enumeration Date
- Mar 30, 2017
- Last Updated
- Jun 30, 2017
Practice Location
- Address
- 5805 MCNUTT RD
- Address 2
- STE D
- City
- Santa Teresa
- State
- New Mexico
- ZIP Code
- 88008-8001
- Phone
- (575) 265-1717
Authorized Official
- Name
- CHRISTIAN LIRA
- Title
- MANAGER
- Phone
- (915) 202-3232
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Prescribing (Medical) — Prescribing (Medical) |
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