Individual
MS. GERALDINE RAE WALMSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
HC 81 BOX 362B, LAS VEGAS, NM 87701-9570
(505) 425-1969
Mailing address
HC 81 BOX 362B, LAS VEGAS, NM 87701-9570
(505) 425-1969
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
P.T. 345
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
345
P.T. LICENSE
NM
Enumeration date
05/24/2007
Last updated
07/08/2007
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