Individual
KIMBERLY A GOODNITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
427 MAIN ST, PECATONICA, IL 61063-7737
(815) 239-1121
(815) 239-2766
Mailing address
PO BOX 699, PECATONICA, IL 61063-0699
(815) 239-1121
(815) 239-2766
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227011185
IL
Other
Enumeration date
09/07/2010
Last updated
09/07/2010
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