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General NPI Number Information
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NPI Number | 1528617446
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Entity Type | Organization
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Legal Business Name | NM STEM CELL, LLC
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Dates
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Enumeration Date | 09/04/2019
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 918 PINEHURST RD., SUITE 102
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City | RIO RANCHO
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State | NM
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Zip | 87124-1068
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Country | US
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Telephone | 505-404-9555
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Fax |
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Provider Business Mailing Address
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Address Line | 918 PINEHURST RD SE STE 102
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City | RIO RANCHO
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State | NM
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Zip | 87124-2568
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Country | US
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Telephone | 505-404-9555
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LONNIE PEETS
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Credential | DC DABCN
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Telephone | 505-554-9048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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