Individual
ELLEN MARGARETA SANTISTEVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
335 LUNA ST SE, LOS LUNAS, NM 87031-9277
(505) 250-4483
Mailing address
6 MILLS LN NE, LOS LUNAS, NM 87031-9597
(505) 865-0355
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6535
NM
Other
Enumeration date
03/08/2010
Last updated
03/08/2010
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