Individual
ALICIA M DIRKSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2536 FARRAGUT DR, SPRINGFIELD, IL 62704-1540
(217) 971-7647
Mailing address
2944 FLOWERBROOK CT, SPRINGFIELD, IL 62702-3321
(217) 971-7647
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.021975
IL
225700000X
Massage Therapist
53526
CA
Other
Enumeration date
03/12/2021
Last updated
03/12/2021
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