Individual
LAURA RENEE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
308 E LINCOLN HWY, DEKALB, IL 60115-3338
(815) 999-8200
Mailing address
308 E LINCOLN HWY, DEKALB, IL 60115-3338
(815) 999-8200
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
227.022717
IL
225700000X
Massage Therapist
Primary
227022717
IL
Other
Enumeration date
09/12/2022
Last updated
10/14/2022
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