Individual
LONN MARCH WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLT,MMP
Contact information
Practice address
3317 FINLEY RD STE 223, IRVING, TX 75062-3200
(512) 897-5163
Mailing address
214 W UNION BOWER RD APT 118, IRVING, TX 75061-7516
(512) 897-5163
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT112763
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT112763
LICENSE
TX
Enumeration date
04/05/2022
Last updated
04/09/2022
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