MEDICARE: MS. ZULMA M. DURAN LLMT #4964

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	#4964	NM

General Provider Information

NPI Number	:	1518163179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ZULMA M. DURAN LLMT #4964

Provider Business Mailing Address
First Line	:	1249 7TH ST NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-1241
Country	:	US
Telephone Number	:	505-269-7157
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 GOLD AVE SW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-3283
Country	:	US
Telephone Number	:	505-269-7157
Fax Number	:

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

Provider Enumeration Date	:	06/21/2007
Last Update Date	:	07/08/2007

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