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Organization
NEW AGE MEDICAL & WELLNESS LLC
Active
Organization
NEW AGE MEDICAL & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE FONSECA (OWNER)
(253) 777-2230
Entity
Organization
Contact information
Practice address
18626 HARDY OAK BLVD, SAN ANTONIO, TX 78258-4210
(253) 777-2230
Mailing address
28910 POMEGRANATE RD, BOERNE, TX 78006-2194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/17/2024
Last updated
11/01/2024
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