Individual
MS. LISA ANN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.M
Contact information
Practice address
1433 MONTEREY DR, SANTA FE, NM 87505-3863
(505) 989-4038
Mailing address
1433 MONTEREY DR, SANTA FE, NM 87505-3863
(505) 989-4038
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
181
NM
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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