MEDICARE: CATHERINE CARNELL LMT

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
1	225700000X	Massage Therapist	8396	NM

General Provider Information

NPI Number	:	1982057311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE CARNELL LMT

Provider Business Mailing Address
First Line	:	1462 GOLDEN EYE LOOP NE
Second Line	:
City	:	RIO RANCHO
State	:	NM
Zip	:	87144-5485
Country	:	US
Telephone Number	:	505-506-0321
Fax Number	:

Provider Business Practice Location Address
First Line	:	1924 JUAN TABO BLVD NE STE F
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87112-3358
Country	:	US
Telephone Number	:	505-633-2756
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2016
Last Update Date	:	02/14/2024

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Directions to “ CATHERINE CARNELL LMT” Practice Location

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