Individual
TRESA CAROL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
201 GAVILAN CANYON ROAD, RUIDOSO, NM 88345
(505) 937-0518
Mailing address
PO BOX 7191, RUIDOSO, NM 88355-7191
(505) 937-0518
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3292
NM
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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