Individual
LISA D KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, RYT
Contact information
Practice address
321 MAIN ST STE 7&8, NIANTIC, CT 06357-3127
(860) 440-6418
Mailing address
321 MAIN ST STE 7&8, NIANTIC, CT 06357-3127
(860) 440-6418
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
006640
CT
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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