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General NPI Number Information
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NPI Number | 1881863819
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Entity Type | Individual
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Provider Name | PATRICIA LEE DE MARSH LMT CMT NMT
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Gender | Female
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 901 3RD ST NW STE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87102
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Country | US
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Telephone | 505-453-4956
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Fax | 505-242-4300
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Provider Business Mailing Address
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Address Line | P.O. BOX 350176
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City | ALBUQUERQUE
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State | NM
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Zip | 87176
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Country | US
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Telephone | 505-453-4956
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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 | 5169
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License Number State | NM
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