Individual
MRS. JENNIFER LOVELL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
102 W 2ND AVE, INDIANOLA, IA 50125-2522
(515) 962-2166
Mailing address
508 E 3RD AVE, INDIANOLA, IA 50125-2945
(319) 202-5555
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
005932
IA
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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