Individual
MISS KRISTIN ROSELENA LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, LMT, NTS
Contact information
Practice address
901 DOUGLAS AVE, LAS VEGAS, NM 87701-3928
(505) 454-5719
Mailing address
412 GIRARD BLVD SE, ALBUQUERQUE, NM 87106-2234
(518) 409-0551
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
4527
NM
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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