Individual
LAURA JOLLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1963 KIVA RD, SANTA FE, NM 87505-3314
(505) 983-6733
Mailing address
1963 KIVA RD, SANTA FE, NM 87505-3314
(505) 983-6733
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT3474
NM
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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