Individual
MIA JADE PALOMARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
5700 COLLEGE BLVD, FARMINGTON, NM 87402-1773
(505) 599-8880
Mailing address
404 S SCHWARTZ AVE APT 107, FARMINGTON, NM 87401-1314
(915) 781-5668
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
888
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/11/2021
Last updated
08/06/2022
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