Organization
KIDNEY WELLNESS CENTER LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSVALDO RENE DE LA VEGA MD (MANAGING MEMBER)
(575) 496-9501
Entity
Organization
Contact information
Practice address
755 S TELSHOR BLVD STE 101, LAS CRUCES, NM 88011-4688
(575) 496-9501
Mailing address
6825 BRIGHT VIEW RD, LAS CRUCES, NM 88007-8935
(575) 496-9501
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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