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General NPI Number Information
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NPI Number | 1972366276
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Entity Type | Individual
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Provider Name | KYLE SCHLUETER LMT
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Gender | Male
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Dates
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Enumeration Date | 01/31/2024
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Last Update Date | 03/02/2024
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Provider Practice Location Address
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Address Line | 4200 MEADOWLARK LN SE STE 3
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City | RIO RANCHO
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State | NM
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Zip | 87124-1050
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Country | US
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Telephone | 505-717-5760
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Fax |
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Provider Business Mailing Address
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Address Line | 2488 NANTUCKET CT NE
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City | RIO RANCHO
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State | NM
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Zip | 87124-2532
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Country | US
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Telephone | 505-717-5760
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Fax |
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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 | MT9137
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License Number State | NM
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