| NPI | 1306343215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDRA GENDUSO Owner 505-690-6679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NM 4830) |
| Enumeration Date | 2018-04-07 |
| Last Update Date | 2022-03-16 |