Individual
GREG ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MASSAGE THERAPIST
Contact information
Practice address
6855 4TH ST NW STE B-2, LOS RANCHOS, NM 87107-6100
(505) 508-2752
Mailing address
397 BUFFALO CIR SE, ALBUQUERQUE, NM 87123-3524
(505) 489-3903
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
S-0553
NM
Other
Enumeration date
09/22/2018
Last updated
09/22/2018
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