Organization
SPINE & MUSCLE REHABILITATION
Active
Parent organization
SPINE & MUSCLE REHAB
Other names
Rainbow's Legacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPINE & MUSCLE REHAB
Authorized official
MISS RAQUEL MARIE EMANUEL LMT, RMTI, CNMT (OFFICE MANAGER)
(575) 525-9960
Entity
Organization
Contact information
Practice address
1605 EL PASEO RD, SUITE C, LAS CRUCES, NM 88001-6010
(575) 525-9960
(575) 525-9958
Mailing address
1605 EL PASEO RD, SUITE C, LAS CRUCES, NM 88001-6010
(575) 525-9960
(575) 525-9958
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
5603
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212488172
—
NM
Enumeration date
06/23/2015
Last updated
06/23/2015
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