Individual
JILL D MCCLEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1415 UNIVERSITY BLVD NE, ALBUQUERQUE, NM 87102-1716
(505) 238-4319
Mailing address
601 NATHAN ST SE, ALBUQUERQUE, NM 87123-3815
(505) 238-4319
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8009
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8009
MASSAGE LISCENSE
NM
Enumeration date
04/28/2020
Last updated
04/28/2020
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