Individual
KAYLA M MATHESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2013 4TH ST, PERU, IL 61354-3208
(815) 414-0905
Mailing address
PO BOX 2, TRIUMPH, IL 61371-0002
(815) 503-1481
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227018699
IL
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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