Individual
MS. GAIL ANNE SUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
0515
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0515
MASSAGE THERAPIST LICENSE
NM
Enumeration date
04/04/2008
Last updated
10/19/2010
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