Individual
CHRISTINE C WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT NCTMB
Contact information
Practice address
9103 PHOENIX VILLAGE PKWY, HEART CENTERED MASSAGE, O FALLON, MO 63368-4279
(630) 338-5408
Mailing address
523 AVENTURA WAY, SAINT PETERS, MO 63376-5927
(630) 338-5408
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2014012307
MO
225700000X
Massage Therapist
227014605
IL
Other
Enumeration date
06/22/2015
Last updated
06/22/2015
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