MEDICARE: ALAYNA J. ROCHE' 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	172M00000X	Mechanotherapist	5211	NM

General Provider Information

NPI Number	:	1801194071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAYNA J. ROCHE' LMT

Provider Business Mailing Address
First Line	:	911 FOUR HILLS RD SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87123-4337
Country	:	US
Telephone Number	:	505-315-2618
Fax Number	:

Provider Business Practice Location Address
First Line	:	911 FOUR HILLS RD
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87123-4334
Country	:	US
Telephone Number	:	505-315-2618
Fax Number	:

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

Provider Enumeration Date	:	03/11/2011
Last Update Date	:	03/11/2011

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