Individual
MRS. LISA MICHELLE PENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1719 GIRARD BLVD NE, ALBUQUERQUE, NM 87106-1718
(505) 265-3400
(505) 265-3404
Mailing address
1719 GIRARD BLVD NE, ALBUQUERQUE, NM 87106-1718
(505) 265-3400
(505) 265-3404
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5712
NM
Other
Enumeration date
10/02/2007
Last updated
10/02/2007
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