| NPI | 1962127878 |
|---|---|
| Doing Business As | MARIPOSA TRANSFORMATION WELLNESS CENTER & MED SPA |
| Entity Type | Organization |
| Authorized Contact | MICHELLE RENEE LUCERO Pa C / Owner 505-234-6432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2023-03-30 |