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General NPI Number Information
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NPI Number | 1275388779
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Entity Type | Individual
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Provider Name | LORIBETH OXFORD NEWMAN
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Gender | Female
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Dates
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Enumeration Date | 04/19/2024
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 23425 N 39TH DR STE 103
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City | GLENDALE
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State | AZ
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Zip | 85310-4197
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Country | US
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Telephone | 623-329-7786
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Fax |
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Provider Business Mailing Address
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Address Line | 4039 W CAMINO ACEQUIA
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City | PHOENIX
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State | AZ
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Zip | 85051-1064
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Country | US
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Telephone | 623-329-7786
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT24520
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License Number State | AZ
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