Individual
MONICA MALCOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1932 S MAIN ST, EUREKA, IL 61530-1666
(309) 467-5000
Mailing address
1198 MAPLE LN, EAST PEORIA, IL 61611-1236
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.016045
IL
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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