Organization
WELLSPRING OF LIFE ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY MCMAHON (OWNER)
(575) 420-1609
Entity
Organization
Contact information
Practice address
109 W BLAND ST, ROSWELL, NM 88203-5708
(575) 420-1609
Mailing address
PO BOX 711, ROSWELL, NM 88202-0711
(575) 420-1609
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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