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Individual

MAVIS NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5300 SEQUOIA RD NW STE 101, ALBUQUERQUE, NM 87120-1288
(505) 289-6718
Mailing address
5300 SEQUOIA RD NW STE 101, ALBUQUERQUE, NM 87120-1288
(505) 289-6718

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8491
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8491
MASSAGE THERAPIST
NM
Enumeration date
03/14/2017
Last updated
03/06/2023
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