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Individual

COREY DILLOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC , LMT

Contact information

Practice address
200 GREENLEAVES BLVD STE 11, MANDEVILLE, LA 70448-7092
(630) 930-4035
Mailing address
236 CALUMET DR, MADISONVILLE, LA 70447-9110
(630) 930-4035

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
323918
LA
225700000X
Massage Therapist
LA9196
LA

Other

Enumeration date
11/05/2020
Last updated
11/05/2020
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