Individual
MRS. DANIELLE LEE KVIDERA MENDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP, MMP
Contact information
Practice address
642 KENTUCKY DERBY LN, LILLINGTON, NC 27546-9742
(541) 218-0584
Mailing address
5843 RAMSEY ST, FAYETTEVILLE, NC 28311-3467
(910) 818-2513
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14605
NC
Other
Enumeration date
09/15/2009
Last updated
02/17/2019
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