Individual
AUDREY BLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1540 32ND CIR SE, RIO RANCHO, NM 87124-1914
(505) 433-9007
Mailing address
1540 32ND CIR SE, RIO RANCHO, NM 87124-1914
(505) 433-9007
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT9386
NM
Other
Enumeration date
01/22/2021
Last updated
01/22/2021
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