MR. Jose Lara III, L.M.T

NPI #1356779607 in San Tan Valley, Arizona

Provider Information

NPI Number: 1356779607
Entity Type: Individual
Name: MR. Jose Lara III, L.M.T
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: L.M.T
Enumeration Date: Oct 24, 2013
Last Updated: Oct 24, 2013

Practice Location

Address: 436 E BRADSTOCK WAY
City: San Tan Valley
State: Arizona
ZIP Code: 85140-5773
Phone: (480) 244-5128

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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