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Organization

DIVINE WELLNESS AND PRIMARY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LARISSA BALDONADO NP (OWNER/NP)
(505) 720-5212
Entity
Organization

Contact information

Practice address
2235 MAIN ST SE STE C, LOS LUNAS, NM 87031-8889
(505) 720-5212
Mailing address
2235 MAIN ST SE STE C, LOS LUNAS, NM 87031-8889

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
06/18/2026
Last updated
06/18/2026
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