Individual
ADELA B MASCARENAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
179 BRIDGE ST, LAS VEGAS, NM 87701-3495
(505) 426-2318
Mailing address
23760 SE TILLSTROM RD, DAMASCUS, OR 97089-6174
(503) 544-2525
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4215
NM
Other
Enumeration date
11/20/2012
Last updated
11/20/2012
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