Individual
KERI JO SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
328 HERITAGE PL, STE. A, FARIBAULT, MN 55021-5251
(507) 332-0202
(507) 332-2206
Mailing address
328 HERITAGE PL, STE. A, FARIBAULT, MN 55021-5251
(507) 332-0202
(507) 332-2206
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2545
CITY OF FARIBAULT LICENSE
MN
Enumeration date
10/25/2006
Last updated
07/08/2007
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