Individual
BIANCA XENIA CORONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CMMP
Contact information
Practice address
8004 ABBEVILLE AVE, LUBBOCK, TX 79424-2806
(806) 252-1355
Mailing address
3626 59TH ST, LUBBOCK, TX 79413-4750
(806) 252-1355
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT112364
TX
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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