Individual
KIRSTIE SEGARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
902 STATE ROAD 570, RANCHOS DE TAOS, NM 87557-7916
(575) 770-1274
Mailing address
902 STATE RD 570, RANCHOS DE TAOS, NM 87557
(575) 770-1274
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4888
NM
Other
Enumeration date
10/01/2009
Last updated
10/01/2009
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