SOUTHWEST WELLNESS NPI 1295158954

NPI Information

SOUTHWEST WELLNESS is a primary care clinic center in Silver City, NM. SOUTHWEST WELLNESS NPI is 1295158954. The provider is registered as an organization entity type.
The provider Is Doing Business As La Clinica.

The provider's business location address is:

3201 N RIDGE LOOP DR
SILVER CITY, NM
ZIP 88061-243
Phone: (575) 388-4251
Fax: (575) 388-4514

The provider's authorized official is Shauna Michelle Mccosh .
The authorized official title is Owner and has the following contact phone number (575) 388-4251.

The CLIA number assigned to this NPI record is 32D2087003 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/30/2014 and was last updated on 1/30/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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