Organization
VIBRANCY VIP MEDCLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONJA MAILMAN (CLINIC MANAGER)
(505) 309-3496
Entity
Organization
Contact information
Practice address
4801 ALAMEDA BLVD NE STE A, ALBUQUERQUE, NM 87113-1532
(505) 309-3496
(505) 441-2736
Mailing address
4801 ALAMEDA BLVD NE STE A, ALBUQUERQUE, NM 87113-1532
(505) 309-3496
(505) 441-2736
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
08/02/2022
Last updated
08/02/2022
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