Individual
ANGELA TIPTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1107 CANYON RD, SANTA FE, NM 87501-6125
(858) 243-8635
Mailing address
1107 CANYON RD, SANTA FE, NM 87501-6125
(858) 243-8635
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
7406
NM
Other
Enumeration date
05/09/2013
Last updated
05/09/2013
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