Organization
INTEGRATED FAMILY WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PHILOMENA E MARCUS CFNP (OWNER)
(505) 293-1658
Entity
Organization
Contact information
Practice address
8300 SAN PEDRO DR NE, ALBUQUERQUE, NM 87113-1703
(505) 293-1658
(505) 298-4737
Mailing address
8300 SAN PEDRO DR NE, ALBUQUERQUE, NM 87113-1703
(505) 293-1658
(505) 298-4737
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R25188
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94108897
—
NM
Enumeration date
08/24/2011
Last updated
08/24/2011
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