Individual
MISS PENNY MARIE IRISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5515 UTICA RIDGE RD, DAVENPORT, IA 52807-3928
(563) 344-1050
(563) 424-4579
Mailing address
3 MARY LANE CT, GENESEO, IL 61254-9578
(309) 716-1846
(563) 424-4579
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
006508
IL
225700000X
Massage Therapist
Primary
227.014374
IA
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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