Individual
TERRY J HARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
48 DIAMOND S LN, BOX 2609, MORIARTY, NM 87035-2609
(505) 321-6884
Mailing address
48 DIAMOND S LN, PO BOX 2609, MORIARTY, NM 87035-2609
(505) 321-6884
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7499
NM
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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