Individual
MRS. ROBERTA ALBINA LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT ATC
Contact information
Practice address
624 UNIVERSITY AVE, STE 100, LAS VEGAS, NM 87701-4252
(505) 454-1078
(505) 454-1164
Mailing address
624 UNIVERSITY AVE, STE 100, LAS VEGAS, NM 87701-4252
(575) 472-8946
(575) 472-8948
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3441
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81308264
—
NM
Enumeration date
09/26/2007
Last updated
10/25/2017
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