Individual
KENT SALAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8612 SUNDORO PL NW, ALBUQUERQUE, NM 87120-1070
(505) 977-5589
Mailing address
8612 SUNDORO PL NW, ALBUQUERQUE, NM 87120-1070
(505) 977-5589
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NMJ837242612
BLUECROSS BLUESHIELD
—
Enumeration date
08/01/2016
Last updated
08/01/2016
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