Individual
IVAN BLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
2725 CAMINO CHUECO, SANTA FE, NM 87505-5249
(786) 246-8005
Mailing address
2725 CAMINO CHUECO, SANTA FE, NM 87505-5249
(786) 246-8005
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5067
NM
Other
Enumeration date
12/17/2015
Last updated
12/17/2015
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