Individual
GILBERTO RIVERA BONILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
8125 MONTEREY EAST AVE NE, ALBUQUERQUE, NM 87109-1733
(505) 710-2603
Mailing address
PO BOX 94645, ALBUQUERQUE, NM 87199-4645
(505) 710-2603
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8747
NM
Other
Enumeration date
02/27/2023
Last updated
02/27/2023
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