Healthcare Provider Details

I. General information

NPI: 1811123383
Provider Name (Legal Business Name): DENISE RINEHART LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2009
Last Update Date: 06/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5341 WYOMING BLVD NE
ALBUQUERQUE NM
87109-3164
US

IV. Provider business mailing address

5232 SUGARBEAR CT NW
ALBUQUERQUE NM
87120-1057
US

V. Phone/Fax

Practice location:
  • Phone: 505-822-1490
  • Fax:
Mailing address:
  • Phone: 505-459-2167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number6196
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: