Individual
ANTONIO C QUINTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
123 VISTA DE VALLE ROAD, RANCHOS DE TAOS, NM 87557
(505) 751-3266
Mailing address
5170 NDCBU, TAOS, NM 87571-6146
(505) 751-3266
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT 4973
NM
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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