Individual
JODIE L LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
731 HASTINGS ST, MOUNT VERNON, MO 65712-1077
(417) 366-4654
Mailing address
18475 LAWRENCE 2100, MOUNT VERNON, MO 65712-8169
(417) 366-0911
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2023022867
MO
Other
Enumeration date
04/09/2025
Last updated
04/22/2025
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