Laura Jolly, LMT

Individual provider Active NPI Massage Therapist · Santa Fe, NM

NPI 1003423872 · NPPES record last updated Sep 25, 2020

Key facts

NPI
1003423872
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT3474 (NM)
Practice address
1963 Kiva Rd
Santa Fe, NM 87505-3314
Phone
(505) 983-6733
NPI assigned
Sep 25, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MT3474NMMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT3474 NM Yes

Addresses

Primary practice location

1963 Kiva Rd
Santa Fe, NM 87505-3314

Mailing address

1963 Kiva Rd
Santa Fe, NM 87505-3314
Phone (505) 983-6733

Other providers in Santa Fe, NM

All providers in Santa Fe, NM · Massage Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.