Individual
MRS. STORMIE DEE MOSIMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P. T.
Contact information
Practice address
160 HOSPITAL DR, RATON, NM 87740-2002
(505) 445-0111
Mailing address
PO BOX 608, RATON, NM 87740-0608
(505) 445-0111
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3433
NM
Other
Enumeration date
08/30/2007
Last updated
08/30/2007
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