Individual
JAMI LYN IRVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1222 LINN ST, SIKESTON, MO 63801-3402
(573) 471-1230
Mailing address
1222 LINN ST, SIKESTON, MO 63801-3402
(573) 471-1230
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2010001412
MO
Other
Enumeration date
04/07/2012
Last updated
04/07/2012
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