Individual
SHANE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MT22009
Contact information
Practice address
1005 21ST ST SE STE 9, RIO RANCHO, NM 87124-4030
(505) 239-9644
(505) 896-2958
Mailing address
1005 21ST ST SE STE 9, RIO RANCHO, NM 87124-4030
(505) 239-9644
(505) 896-2958
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT22009
NM
Other
Enumeration date
02/27/2023
Last updated
02/27/2023
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