Individual
RUTI WAGAKI RAPHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1925 ASPEN DR, SANTA FE, NM 87505-5459
(505) 629-6507
Mailing address
PO BOX 1282, SANTA FE, NM 87504-1282
(505) 629-6507
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
5890
OR
225700000X
Massage Therapist
Primary
7075
NM
Other
Enumeration date
03/11/2013
Last updated
10/10/2016
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