Individual
AMY DIANE LAGRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4700 JEFFERSON ST NE, SUITE 100, ALBUQUERQUE, NM 87109-2136
(505) 925-7464
(505) 925-4539
Mailing address
933 BRADBURY SE, SUITE 2222, ALBUQUERQUE, NM 87106-4301
(505) 272-2521
(505) 272-3238
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4833
NM
Other
Enumeration date
12/08/2011
Last updated
12/08/2011
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