Healthcare Provider Details

I. General information

NPI: 1730966912
Provider Name (Legal Business Name): ALL WIN WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2023
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 JEFFERSON ST NE
ALBUQUERQUE NM
87109-4313
US

IV. Provider business mailing address

5901-J WYOMING BLVD NE PMB 396
ALBUQUERQUE NM
87109
US

V. Phone/Fax

Practice location:
  • Phone: 505-344-9478
  • Fax:
Mailing address:
  • Phone: 505-344-9478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: AURORA AUWEN
Title or Position: OWNER
Credential: MD
Phone: 505-373-2224