Individual
MISS STELLA JEANNE BURCIAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
601 E LINCOLN ST, LAS VEGAS, NM 87701-4502
(505) 425-2998
(505) 425-2897
Mailing address
154 ROADRUNNER, LAS VEGAS, NM 87701
(505) 718-8309
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3283
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36072842
—
NM
Enumeration date
03/06/2007
Last updated
12/27/2018
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