Individual
LISA WENGERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CST
Contact information
Practice address
624 APPLEWOOD PARK DR SE, RIO RANCHO, NM 87124-7120
(505) 264-8267
Mailing address
624 APPLEWOOD PARK DR SE, RIO RANCHO, NM 87124-7120
(505) 264-8267
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6662
NM
Other
Enumeration date
10/31/2007
Last updated
08/22/2016
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