Individual
ANN M MICONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSE MASSAGE THER
Contact information
Practice address
4436 CORRALES RD, CORRALES, NM 87048
(505) 507-1654
Mailing address
PO BOX 66443, ANN MICONO MASSAGE THERAPY, ALBUQUERQUE, NM 87193
(505) 507-1654
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4904
NM
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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