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1821189473
LISA JILL MICK
ALBUQUERQUE, NM
NPI
1821189473
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
(Licence: NM 1421)
Enumeration Date
2006-09-27
Last Update Date
2007-07-08
Business Address
-- LISA JILL MICK OT
5200 COPPER AVE NE
ALBUQUERQUE, NM 87108-1473
Phone number: 505-255-5099
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Mailing Address
-- LISA JILL MICK OT
5200 COPPER AVE NE
ALBUQUERQUE, NM 87108-1473
Phone number: 505-255-5099
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