Healthcare Provider Details

I. General information

NPI: 1275320582
Provider Name (Legal Business Name): JOY N STROMBERG LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 04/21/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 WEST MAIN STREET 6
RED RIVER NM
87558-0372
US

IV. Provider business mailing address

PO BOX 372
RED RIVER NM
87558-0372
US

V. Phone/Fax

Practice location:
  • Phone: 575-779-7966
  • Fax:
Mailing address:
  • Phone: 575-779-7966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT7641
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: