| NPI | 1043680028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER FOWLER Medical Massage Therapist 505-660-9110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NM 5906) |
| Enumeration Date | 2015-10-02 |
| Last Update Date | 2015-12-15 |