Individual
STAR AMBER RIDSDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1005 21ST ST SE, SUITE #9, RIO RANCHO, NM 87124-4030
(505) 239-9644
(505) 896-2958
Mailing address
10900 TANZANITE DR NW, ALBUQUERQUE, NM 87114-1853
(505) 239-9644
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1435
NM
Other
Enumeration date
01/24/2007
Last updated
01/13/2017
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