Individual
KATHY JEAN PERRTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
400 MIMS ST, TRUTH OR CONSEQUENCES, NM 87901-3376
(575) 894-4325
Mailing address
400 MIMS ST, TRUTH OR CONSEQUENCES, NM 87901-3376
(575) 894-4325
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
5961
NM
171W00000X
Contractor
MA 36078
FL
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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