Individual
MRS. JAMIE LYNN FANARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
JAMIE FANARA, LCMT
Contact information
Practice address
461 N. MULFORD ROAD, UNIT 8, ROCKFORD, IL 61107
(815) 977-4743
Mailing address
461 N. MULFORD ROAD, UNIT 8, ROCKFORD, IL 61107
(815) 977-4743
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.005581
IL
Other
Enumeration date
04/08/2011
Last updated
04/08/2011
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