Individual
MARIELA NELLY MONTENEGRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
114 SOUTHBRIDGE ST, SAN ANTONIO, TX 78216-6264
(210) 548-9128
Mailing address
114 SOUTHBRIDGE ST, SAN ANTONIO, TX 78216-6264
(210) 548-9128
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT120921
TX
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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