Individual
DANIEL LEE LEDBETTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
216 W 1ST ST, ROSWELL, NM 88203-4602
(505) 625-5536
Mailing address
PO BOX 204, HAGERMAN, NM 88232-0204
(505) 625-5536
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3528
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00RL28
BLUE CROSS BLUE SHIELD
NM
Enumeration date
02/02/2007
Last updated
07/08/2007
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