Individual
MRS. MARCIA H TRUJILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2905 N PRINCE ST STE C, CLOVIS, NM 88101-3843
(505) 714-4395
Mailing address
1629 S AVENUE C, PORTALES, NM 88130-7207
(505) 226-0045
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5327
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00RE88
BLUE CROSS BLUE SHIELD
NM
Enumeration date
03/12/2007
Last updated
07/08/2007
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