Individual
TEVERLY LYNN LAZENBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT, LMT
Contact information
Practice address
230 W COLLEGE ST, SUITE E, COVINA, CA 91723-1911
(626) 827-8836
Mailing address
230 W COLLEGE ST, SUITE E, COVINA, CA 91723-1911
(626) 827-8836
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11554
CA
Other
Enumeration date
08/16/2010
Last updated
08/16/2010
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