Individual
VALE A TSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2620 SAN MATEO BLVD NE STE G, ALBUQUERQUE, NM 87110-3163
(505) 239-9644
(505) 896-2958
Mailing address
10900 TANZANITE DR NW, ALBUQUERQUE, NM 87114-1853
(505) 239-9644
(505) 896-2958
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT9326
NM
Other
Enumeration date
05/07/2021
Last updated
05/07/2021
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