Letishia Lyne Eide, LMT

NPI #1669687430 in Malvern, Arkansas

Provider Information

NPI Number: 1669687430
Entity Type: Individual
Name: Letishia Lyne Eide, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: LMT
Enumeration Date: May 14, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 910 DYER ST
City: Malvern
State: Arkansas
ZIP Code: 72104-5253
Phone: (501) 467-4445

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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