Most Relevant Information
Provider Data
| NPI Number: | 1003423872 |
| Provider Name: | LAURA JOLLY LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | MT3474 |
Most Important Dates
| Enumeration Date: | 09/25/2020 |
| Last Updated: | 09/25/2020 |
Provider Practice Location
1963 KIVA RD
SANTA FE
NM
875053314
Practice Location Phone/Fax
| Phone: | 5059836733 |
| Fax: |
Provider Mailing Location
1963 KIVA RD
SANTA FE
NM
875053314
Provider Mailing Phone/Fax
| Phone: | 5059836733 |
| Fax: |