Organization
TLC MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE M MOUCHETTE (OWNER)
(575) 373-8415
Entity
Organization
Contact information
Practice address
2801 MISSOURI AVE, SUITE 7, LAS CRUCES, NM 88011-5075
(575) 373-8415
(575) 373-8416
Mailing address
2801 MISSOURI AVE, SUITE 7, LAS CRUCES, NM 88011-5075
(575) 373-8415
(575) 373-8416
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
07/28/2011
Last updated
08/10/2012
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