Provider Demographics
NPI:1982402145
Name:REID, ABIGAIL S
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:S
Last Name:REID
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 SCHULTE RD NW
Mailing Address - Street 2:
Mailing Address - City:LOS RANCHOS
Mailing Address - State:NM
Mailing Address - Zip Code:87107-6133
Mailing Address - Country:US
Mailing Address - Phone:505-382-5182
Mailing Address - Fax:
Practice Address - Street 1:705 GRACE ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-1232
Practice Address - Country:US
Practice Address - Phone:505-382-5182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist