Provider Demographics
NPI:1801194071
Name:ROCHE', ALAYNA J (LMT)
Entity Type:Individual
Prefix:
First Name:ALAYNA
Middle Name:J
Last Name:ROCHE'
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 FOUR HILLS RD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-4337
Mailing Address - Country:US
Mailing Address - Phone:505-315-2618
Mailing Address - Fax:
Practice Address - Street 1:911 FOUR HILLS RD
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-4334
Practice Address - Country:US
Practice Address - Phone:505-315-2618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5211172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist