Healthcare Provider Details

I. General information

NPI: 1255663027
Provider Name (Legal Business Name): CONNIE STROMEI LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 09/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6341 RIVERSIDE PLAZA LN NW SUITE B
ALBUQUERQUE NM
87120-2646
US

IV. Provider business mailing address

PO BOX 66328
ALBUQUERQUE NM
87193-6328
US

V. Phone/Fax

Practice location:
  • Phone: 505-550-9933
  • Fax: 505-792-7587
Mailing address:
  • Phone: 505-550-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number3804
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: