Healthcare Provider Details

I. General information

NPI: 1720108343
Provider Name (Legal Business Name): JOEL F ROMIG LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 OAK ST NE STE 101
ALBUQUERQUE NM
87106-4738
US

IV. Provider business mailing address

7717 WHITE ST NE
ALBUQUERQUE NM
87109-5246
US

V. Phone/Fax

Practice location:
  • Phone: 505-790-9079
  • Fax:
Mailing address:
  • Phone: 505-790-9079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number3043
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: