Healthcare Provider Details

I. General information

NPI: 1134457286
Provider Name (Legal Business Name): ISABEL C GARCIA MASSAGE THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2009
Last Update Date: 12/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7007 JEFFERSON ST NE STE C
ALBUQUERQUE NM
87109-4450
US

IV. Provider business mailing address

7007 JEFFERSON ST NE STE C
ALBUQUERQUE NM
87109-4450
US

V. Phone/Fax

Practice location:
  • Phone: 505-821-4325
  • Fax: 505-822-8460
Mailing address:
  • Phone: 505-821-4325
  • Fax: 505-822-8460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: