Individual
KAI MARIE THEOPHILUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2322 KIMO DR NE, ALBUQUERQUE, NM 87110-4024
(505) 688-6350
Mailing address
2322 KIMO DR NE, ALBUQUERQUE, NM 87110-4024
(505) 688-6350
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5347
NM
Other
Enumeration date
04/18/2017
Last updated
05/05/2017
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