Individual
LILLIAN DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
360 RICE ST, ELMORE, OH 43416-9422
(419) 463-2559
Mailing address
1818 HAYES AVE, FREMONT, OH 43420-2709
(419) 463-2559
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
022222
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022222
LICENSED MASSAGE THERAPIST
OH
Enumeration date
06/29/2017
Last updated
06/29/2017
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