Mary Jo Carter, LMT
Individual provider Active NPI Massage Therapist · Gallina, NM
NPI 1215066063 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1215066063
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 263 (NM)
- Practice address
- RT 78
Gallina, NM 87017 - Phone
- (505) 638-1015
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 263 | NM | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 263 | NM | Yes |
Addresses
Primary practice location
RT 78
Gallina, NM 87017
Mailing address
RT 78 Box 5
Gallina, NM 87017
Phone (505) 638-1015
Other providers in Gallina, NM
All providers in Gallina, NM · Massage Therapist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.