Provider Demographics
NPI:1124592761
Name:ASTHMA & WELLNESS EDUCATORS LLC
Entity Type:Organization
Organization Name:ASTHMA & WELLNESS EDUCATORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:505-304-9381
Mailing Address - Street 1:896 CASCADE RD SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-4332
Mailing Address - Country:US
Mailing Address - Phone:505-304-9381
Mailing Address - Fax:
Practice Address - Street 1:896 CASCADE RD SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4332
Practice Address - Country:US
Practice Address - Phone:505-304-9381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty