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Individual

MS. CARLA JEAN VANDENBURGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MASSAGE THERAPIST

Contact information

Practice address
1600 LEBANON AVE STE 101, BELLEVILLE, IL 62221-2491
(618) 978-7407
Mailing address
3212 HUNTERS WAY, BELLEVILLE, IL 62221-3471
(618) 978-7407
(618) 277-6672

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
217.011790
IL

Other

Enumeration date
02/20/2013
Last updated
02/20/2013
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