Glenda Clemmer Bly, LMT, RMT
Individual provider Active NPI Massage Therapist · Clovis, NM
NPI 1255485652 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1255485652
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 3498 (NM)
- Practice address
- 2905 N Prince St
Suite C
Clovis, NM 88101-3843 - Phone
- (505) 763-0551
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 3498 | NM | MD | Massage Therapist |
| MT022683 | TX | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 3498 | NM | Yes |
| Massage Therapist | 225700000X | MT022683 | TX |
Addresses
Primary practice location
2905 N Prince St
Suite C
Clovis, NM 88101-3843
Mailing address
PO Box 784
Farwell, TX 79325-0784
Phone (806) 481-8181
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM00RE56 | Other | NM | BLUE CROSS & BLUE SHIELD |
Other names
- Glenda Bly
Other providers in Clovis, NM
- Brittany J Blackmon
- Manuel Blea
- Nicolas Bliss
- Blue and Red Bird Corp PC
- Blue and Red Bird Corporation, PC.
- Arnel Anthony S Bobadilla
- Tyler Bock
- Samantha V Bohn
- Dayna Lee Bolton
- Hannah Bonn
All providers in Clovis, 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.