Individual
LISABETH DETWILER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DOM
Contact information
Practice address
3904 CENTRAL AVE SE, ALBUQUERQUE, NM 87108-1017
(505) 266-0881
Mailing address
2433 CARDENAS DR NE, ALBUQUERQUE, NM 87110-4113
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1127
NM
Other
Enumeration date
02/04/2014
Last updated
09/23/2014
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