Provider Demographics
NPI:1841359395
Name:NEWTON, CLETA F (LMT)
Entity type:Individual
Prefix:MRS
First Name:CLETA
Middle Name:F
Last Name:NEWTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 MAIN ST
Mailing Address - Street 2:SNYDER CLINIC BLDG
Mailing Address - City:CANADIAN
Mailing Address - State:TX
Mailing Address - Zip Code:79014-2216
Mailing Address - Country:US
Mailing Address - Phone:806-217-0520
Mailing Address - Fax:
Practice Address - Street 1:405 MAIN ST
Practice Address - Street 2:SNYDER CLINIC BLDG
Practice Address - City:CANADIAN
Practice Address - State:TX
Practice Address - Zip Code:79014-2216
Practice Address - Country:US
Practice Address - Phone:806-217-0520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT024090225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist