Individual
YULANDIST JEANNIE BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN, LMT
Contact information
Practice address
617 COLUMBUS ST, OTTAWA, IL 61350
(815) 579-8962
Mailing address
617 COLUMBUS ST, OTTAWA, IL 61350-2912
(815) 579-8962
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.121878
IL
225700000X
Massage Therapist
227.019508
IL
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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