Healthcare Provider Details
I. General information
NPI: 1245308287
Provider Name (Legal Business Name): LOYCE CATHRINE DULIN LMT,MMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9301 CANDELARIA RD NE
ALBUQUERQUE NM
87112-1301
US
IV. Provider business mailing address
PO BOX 784
PLACITAS NM
87043-0784
US
V. Phone/Fax
- Phone: 505-293-3703
- Fax:
- Phone: 505-867-3037
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 275 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: