Provider Demographics
NPI:1275320582
Name:STROMBERG, JOY N (LMT)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:N
Last Name:STROMBERG
Suffix:
Gender:
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 372
Mailing Address - Street 2:
Mailing Address - City:RED RIVER
Mailing Address - State:NM
Mailing Address - Zip Code:87558-0372
Mailing Address - Country:US
Mailing Address - Phone:575-779-7966
Mailing Address - Fax:
Practice Address - Street 1:612 WEST MAIN STREET
Practice Address - Street 2:6
Practice Address - City:RED RIVER
Practice Address - State:NM
Practice Address - Zip Code:87558-0372
Practice Address - Country:US
Practice Address - Phone:575-779-7966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMT7641225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty