Andra E. Maddox, LMT

NPI #1548045941 in El Prado, New Mexico

Provider Information

NPI Number: 1548045941
Entity Type: Individual
Name: Andra E. Maddox, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: LMT
Enumeration Date: Aug 25, 2023
Last Updated: Aug 25, 2023

Practice Location

Address: 98 STATE HIGHWAY 150
Address 2: SUITE 7
City: El Prado
State: New Mexico
ZIP Code: 87529-1589
Phone: (575) 776-1117

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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