Individual
GREGORY SANTIAGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1206 E AZTEC AVE STE B, GALLUP, NM 87301-5085
(505) 239-9644
(505) 896-2958
Mailing address
10900 TANZANITE DR NW, ALBUQUERQUE, NM 87114-1853
(505) 239-9644
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT9112
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
273506899
VA
NM
Enumeration date
10/12/2021
Last updated
10/12/2021
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