Individual
LISA TATOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
319 W 50TH ST, ODESSA, TX 79764-4115
(432) 638-2653
(432) 614-9650
Mailing address
319 W 50TH ST, ODESSA, TX 79764-4115
(432) 638-2653
(432) 614-9650
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT122817
TX
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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