Individual
MRS. AMY ELIZABETH MASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-2121
Mailing address
3709 BUCKINGHAM ST, FARMINGTON, NM 87402-4737
(505) 947-4652
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1496
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00073806
—
NM
Enumeration date
05/21/2007
Last updated
07/08/2007
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