Provider Demographics
NPI:1245476886
Name:SANDERS, JOYCE (LMT)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:SANDERS
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:PO BOX 1561
Mailing Address - Street 2:
Mailing Address - City:RUIDOSO DOWNS
Mailing Address - State:NM
Mailing Address - Zip Code:88346-1561
Mailing Address - Country:US
Mailing Address - Phone:575-937-0370
Mailing Address - Fax:
Practice Address - Street 1:101 REESE DR
Practice Address - Street 2:
Practice Address - City:RUIDOSO
Practice Address - State:NM
Practice Address - Zip Code:88345-6017
Practice Address - Country:US
Practice Address - Phone:575-937-0370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-04
Last Update Date:2009-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3608225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist