Individual
CAMILLE RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC,LAT
Contact information
Practice address
1398 WEIMER RD, SUITE 203, TAOS, NM 87571-6397
(575) 737-0304
(575) 737-9445
Mailing address
1398 WEIMER RD, SUITE 203, TAOS, NM 87571-6397
(575) 737-0304
(575) 737-9445
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
644
NM
Other
Enumeration date
02/04/2016
Last updated
02/04/2016
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