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Organization

MIRAGE WELLNESS CENTER & MEDSPA LIMITED LIABILITY COMPANY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELENA MARTINEZ PRACTICE MANAGER (PRACTICE MANAGER)
(505) 420-3737
Entity
Organization

Contact information

Practice address
1400 BARBARA LOOP SE STE A, RIO RANCHO, NM 87124-1088
(505) 420-3737
(505) 420-3738
Mailing address
1400 BARBARA LOOP SE STE A, RIO RANCHO, NM 87124-1088
(505) 420-3737
(505) 420-3738

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Enumeration date
03/23/2026
Last updated
03/23/2026
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