Individual
NICOLE MARTINEZKISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
7801 WILSHIRE AVE NE, LA CUEVA HS, ALBUQUERQUE, NM 87122-2807
(505) 823-2327
Mailing address
7801 WILSHIRE AVE NE, LA CUEVA HS, ALBUQUERQUE, NM 87122-2807
(505) 823-2327
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2622
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B 9931
—
NM
Enumeration date
01/19/2007
Last updated
07/09/2007
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