| Enchantment Healthcare,llc | |
|
106 Main St Ne Suite A Los Lunas NM 87031-7559 | |
| (505) 565-0070 | |
| (505) 565-0978 |
| Full Name | Enchantment Healthcare,llc |
|---|---|
| Speciality | Physician Assistant |
| Location | 106 Main St Ne, Los Lunas, New Mexico |
| Authorized Official Name and Position | Monique Nicole Sisneros (OFFICE MANAGER) |
| Authorized Official Contact | 5056158336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enchantment Healthcare,llc 106 Main St Ne Suite A Los Lunas NM 87031-7559 Ph: (505) 565-0070 | Enchantment Healthcare,llc 106 Main St Ne Suite A Los Lunas NM 87031-7559 Ph: (505) 565-0070 |
| NPI Number | 1962849950 |
|---|---|
| Provider Enumeration Date | 05/30/2013 |
| Last Update Date | 05/30/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962849950 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 84-288 (New Mexico) | Secondary |
| 363A00000X | Physician Assistant | PA2005-0037 (New Mexico) | Primary |
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