Provider Demographics
NPI:1245548619
Name:GARCIA, EMMETT (LMT, CMLDT)
Entity type:Individual
Prefix:MR
First Name:EMMETT
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:LMT, CMLDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 S SAINT FRANCIS DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4050
Mailing Address - Country:US
Mailing Address - Phone:505-459-4007
Mailing Address - Fax:
Practice Address - Street 1:1227 S SAINT FRANCIS DR
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4050
Practice Address - Country:US
Practice Address - Phone:505-459-4007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM6768225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist