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General NPI Number Information
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NPI Number | 1497043848
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Entity Type | Individual
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Provider Name | CAROLYN DENISE EIFERT LMT, CMTPT
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Gender | Female
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 1813 MIRACERROS PLACE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106
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Country | US
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Telephone | 505-449-7230
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Fax | 877-812-7771
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Provider Business Mailing Address
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Address Line | 1813 MIRACERROS PLACE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106
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Country | US
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Telephone | 505-449-7230
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Fax | 877-812-7771
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 6273
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License Number State | NM
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