Organization
PRIMARY WELLNESS TEAM CORPORATION
Active
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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