Individual
LAUREN REESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
5111 N BEND DR, FORT WAYNE, IN 46804-1753
(260) 436-8807
Mailing address
6109 SHADOW RIDGE PL, FORT WAYNE, IN 46804-4297
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT21304814
IN
Other
Enumeration date
09/02/2015
Last updated
09/02/2015
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