Individual
LISA FORMBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
717 CHELSEA DR, MIDLOTHIAN, TX 76065-8739
(214) 949-0902
Mailing address
717 CHELSEA DR, MIDLOTHIAN, TX 76065-8739
(214) 949-0902
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
048837
TX
Other
Enumeration date
02/12/2012
Last updated
02/12/2012
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