Individual
MELLISA MARIE EVERETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3414 NM- 47, LOS LUNAS, NM 87031
(505) 507-4773
Mailing address
90 OTERO RD, LOS LUNAS, NM 87031-5709
(505) 507-4773
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8806
NM
Other
Enumeration date
03/07/2018
Last updated
03/07/2018
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