Healthcare Provider Details

I. General information

NPI: 1386926970
Provider Name (Legal Business Name): ROBBY UNSER L.M.T., N.T.S.,
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2011
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

806 LAGUAYRA DR NE
ALBUQUERQUE NM
87108-1732
US

IV. Provider business mailing address

806 LAGUAYRA DR NE
ALBUQUERQUE NM
87108-1732
US

V. Phone/Fax

Practice location:
  • Phone: 505-917-6709
  • Fax:
Mailing address:
  • Phone: 505-917-6709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number6402
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: