Healthcare Provider Details

I. General information

NPI: 1982710067
Provider Name (Legal Business Name): PATT MACDONALD-CHRISTIE MASSAGE THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA ANN MACDONALD-CHRISTIE MASSAGE THERAPIST

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6117 MCLEOD RD NE
ALBUQUERQUE NM
87109-2640
US

IV. Provider business mailing address

6117 MCLEOD RD NE
ALBUQUERQUE NM
87109-2640
US

V. Phone/Fax

Practice location:
  • Phone: 505-883-7730
  • Fax:
Mailing address:
  • Phone: 505-883-7730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number595
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: