Individual
KATIE MALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
742 N MARKET ST STE D, WATERLOO, IL 62298-1079
(314) 740-2172
Mailing address
742 N MARKET ST STE D, WATERLOO, IL 62298-1079
(314) 740-2172
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.007281
IL
Other
Enumeration date
07/11/2014
Last updated
07/11/2014
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