Individual
JODIE BATY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
815 W MAIN ST, SALEM, IL 62881-1408
(815) 674-1052
Mailing address
7903 BRIMBERRY RD, ALMA, IL 62807-1233
(815) 674-1052
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227003158
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227003158
LICENSED NUMBER
IL
Enumeration date
02/24/2019
Last updated
02/24/2019
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