Individual
ELIZABETH ANN FODERARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
28604 INTERSTATE 10 W UNIT 4, BOERNE, TX 78006-9115
(830) 431-0773
(830) 265-4053
Mailing address
28604 INTERSTATE 10 W UNIT 4, BOERNE, TX 78006-9115
(830) 431-0773
(830) 265-4053
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT003468
TX
Other
Enumeration date
07/25/2019
Last updated
07/25/2019
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