Individual
MARY CLARE LOUISE KAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3600 E STATE ST, ROCKFORD, IL 61108-1978
(815) 721-1378
Mailing address
1512 CAMP AVE, ROCKFORD, IL 61103-6302
(815) 721-1378
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
03/12/2020
Last updated
03/12/2020
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