Organization
BUENA VIDA PHYSICAL THERAPY AND WELLNESS LLC
Active
Organization
BUENA VIDA PHYSICAL THERAPY AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STELLA JEANNE BURCIAGA PT (PRESIDENT)
(505) 718-8309
Entity
Organization
Contact information
Practice address
601 E LINCOLN ST, LAS VEGAS, NM 87701-4502
(505) 425-2998
(505) 425-2897
Mailing address
601 E LINCOLN ST, LAS VEGAS, NM 87701-4502
(505) 425-2998
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
3283
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36072842
—
NM
Enumeration date
06/04/2008
Last updated
04/07/2020
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