Individual
MRS. LOU ELLEN DEMOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
136 W BUFFORD ST, BURLESON, TX 76028-4227
(817) 426-2456
(817) 426-0149
Mailing address
600 PHEASANT RUN, BURLESON, TX 76028-6120
(817) 271-2033
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT106959
TX
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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