Organization
ENCHANTMENT HEALTHCARE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MONIQUE NICOLE SISNEROS (OFFICE MANAGER)
(505) 615-8336
Entity
Organization
Contact information
Practice address
106 MAIN ST NE, SUITE A, LOS LUNAS, NM 87031-7559
(505) 565-0070
(505) 565-0978
Mailing address
106 MAIN ST NE, SUITE A, LOS LUNAS, NM 87031-7559
(505) 565-0070
(505) 565-0978
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
84-288
NM
363A00000X
Physician Assistant
Primary
PA2005-0037
NM
Other
Enumeration date
05/30/2013
Last updated
05/30/2013
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