Provider Demographics
NPI:1275388779
Name:OXFORD NEWMAN, LORIBETH
Entity Type:Individual
Prefix:
First Name:LORIBETH
Middle Name:
Last Name:OXFORD NEWMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4039 W CAMINO ACEQUIA
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-1064
Mailing Address - Country:US
Mailing Address - Phone:623-329-7786
Mailing Address - Fax:
Practice Address - Street 1:23425 N 39TH DR STE 103
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-4197
Practice Address - Country:US
Practice Address - Phone:623-329-7786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT24520225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist