Organization
TOTAL HEALTH AND WELLNESS CENTER OF TAOS INC
Active
Other names
Total Health and Wellness Center of Taos
Organization subpart
No
Provider details
NPI number
Authorized official
JAKE MOSSMAN (PRESIDENT/PHARMACIST IN CHARGE)
(575) 737-5810
Entity
Organization
Contact information
Practice address
622 PASEO DEL PUEBLO SUR STE B, 5401 NDCBU, TAOS, NM 87571-5101
(575) 737-5810
(575) 737-5811
Mailing address
5401 NDCBU, TAOS, NM 87571-6117
(575) 737-5810
(575) 737-5811
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3212040
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/17/2010
Last updated
07/29/2010
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