Individual
MR. JUAN CARLOS ZAVALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MASSAGE THERAPIST
Contact information
Practice address
230 ADAMS ST SE, S.E., ALBUQUERQUE, NM 87108-2805
(505) 843-7492
Mailing address
230 ADAMS STREET, S.E., ALBUQUERQUE, NM 87108
(505) 843-7492
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
LMT 3032
NM
Other
Enumeration date
03/21/2012
Last updated
03/21/2012
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