Individual
MS. MARY JO CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
RT 78, GALLINA, NM 87017
(505) 638-1015
Mailing address
RT 78 BOX 5, GALLINA, NM 87017
(505) 638-1015
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
263
NM
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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