Individual
LISA NEVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3804 PARK AVE STE C, WILMINGTON, NC 28403-6737
(910) 228-9026
Mailing address
1010 NUTT ST APT 3219, WILMINGTON, NC 28401-5485
(910) 228-9026
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3228
NC
Other
Enumeration date
12/10/2021
Last updated
12/10/2021
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