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Organization

LA BONNA VITA COSMETIC SPA, LLC

Active
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Organization

LA BONNA VITA COSMETIC SPA, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES LESTER (MANAGING MEMBER)
(505) 453-7886
Entity
Organization

Contact information

Practice address
4333 PAN AMERICAN FWY NE, SUITE C, ALBUQUERQUE, NM 87107-6831
(505) 344-6334
Mailing address
4333 PAN AMERICAN FWY NE, SUITE C, ALBUQUERQUE, NM 87107-6831
(505) 344-6334

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
89-270
NM

Other

Enumeration date
12/03/2009
Last updated
12/03/2009
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