Individual
MRS. MIAE CHANTILLY CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5115 COORS BLVD NW, ALBUQUERQUE, NM 87120-1900
(505) 897-6560
Mailing address
2101 TORRENT DR NW, ALBUQUERQUE, NM 87120-7122
(808) 283-8880
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MAT-10851
HI
225700000X
Massage Therapist
Primary
NM-2024-0097
NM
Other
Enumeration date
09/27/2024
Last updated
09/27/2024
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