Individual
DEREK MERCHANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
6592 VALLE DEL RIO CT, LA MESA, NM 88044-9670
(575) 202-5359
Mailing address
6592 VALLE DEL RIO CT, LA MESA, NM 88044-9670
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7437
NM
Other
Enumeration date
12/24/2012
Last updated
12/24/2012
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