Individual
MS. VIVIAN DENNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2917 CARLISLE BLVD NE STE 103, ALBUQUERQUE, NM 87110-2849
(505) 974-2412
Mailing address
2917 CARLISLE BLVD NE STE 103, ALBUQUERQUE, NM 87110-2849
50597402413
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8387
NM
Other
Enumeration date
11/05/2007
Last updated
03/17/2018
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