Individual
MRS. JULIE A GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.P.T
Contact information
Practice address
2455 MISSOURI AVE, LAS CRUCES, NM 88001-5122
(575) 522-5852
Mailing address
2455 MISSOURI AVE, SUITE B, LAS CRUCES, NM 88001-5122
(575) 556-8440
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2586
NM
Other
Enumeration date
01/06/2008
Last updated
05/04/2015
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