Organization
PRIMARY WELLNESS TEAM CORPORATION
Active
Other names
Reef Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIAN LIRA (MANAGER)
(915) 202-3232
Entity
Organization
Contact information
Practice address
5805 MCNUTT RD, STE D, SANTA TERESA, NM 88008-8001
(575) 265-1717
Mailing address
205 W BOUTZ RD, BLDG 1, LAS CRUCES, NM 88005-3262
(575) 532-7000
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
—
—
Other
Enumeration date
03/30/2017
Last updated
06/30/2017
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