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NPI Code Detail

MEDICARE: DIA DE MASSAGE, LLC

MEDICARE: DIA DE MASSAGE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist
2225X00000XOccupational Therapist

General Provider Information

NPI Number : 1073482717
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIA DE MASSAGE, LLC
Provider Business Mailing Address
First Line : 135 MADISON ST NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-1238
Country : US
Telephone Number : 505-450-3382
Fax Number :
Provider Business Practice Location Address
First Line : 135 MADISON ST NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-1238
Country : US
Telephone Number : 505-450-3382
Fax Number :
Authorized Official
Title or Position : LICENSED MASSAGE THERAPIST/OWNER
Name : ELIZABETH DILLARD
Credential : LMT
Telephone Number : 505-450-3382
Provider Enumeration Date : 10/31/2025
Last Update Date : 12/23/2025

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Directions to “DIA DE MASSAGE, LLC ” Practice Location

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