Individual
LORRAINE MARGARET SLADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1615 BOREALIS AVE SE, RIO RANCHO, NM 87124-2877
(505) 205-2291
Mailing address
1615 BOREALIS AVE SE, RIO RANCHO, NM 87124-2877
(505) 205-2291
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
LMT #6906
NM
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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