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Individual

MARCIA ALLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA

Contact information

Practice address
5011 MONTGOMERY BLVD NE, SUITE B2, ALBUQUERQUE, NM 87109-1350
(505) 872-3668
(505) 888-7041
Mailing address
5011 MONTGOMERY BLVD NE, SUITE B2, ALBUQUERQUE, NM 87109-1350
(505) 872-3668
(505) 888-7041

Taxonomy

Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
202635927
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05756863
NM
05
1881667806
NM
Enumeration date
11/10/2009
Last updated
11/10/2009
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