MEDICARE: CONSTANCE STAUFFACHER LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	8324	OR
2	225700000X	Massage Therapist	23018	NM

General Provider Information

NPI Number	:	1306395769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONSTANCE STAUFFACHER LMT

Provider Business Mailing Address
First Line	:	3540 SHILOH RD NE
Second Line	:
City	:	RIO RANCHO
State	:	NM
Zip	:	87144-2572
Country	:	US
Telephone Number	:	503-689-5536
Fax Number	:

Provider Business Practice Location Address
First Line	:	4263 MONTGOMERY BLVD NE STE 110
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-6708
Country	:	US
Telephone Number	:	503-689-5536
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2016
Last Update Date	:	03/30/2025

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Directions to “ CONSTANCE STAUFFACHER LMT” Practice Location

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