Organization
MIRA SOL LYMPHEDEMA REHAB CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER STEINMETZ MD (PHYSICIAN)
(505) 647-8366
Entity
Organization
Contact information
Practice address
2455 MISSOURI AVE, SUITE B, LAS CRUCES, NM 88001-5122
(505) 556-8440
(505) 556-8439
Mailing address
PO BOX 1560, LAS CRUCES, NM 88004-1560
(505) 647-8366
(505) 647-8381
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
94078807
—
NM
Enumeration date
10/17/2006
Last updated
12/17/2007
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