Individual
MRS. COLLEENA LEE FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
950 N 1800 EAST RD, SHELBYVILLE, IL 62565-4219
(217) 460-0931
Mailing address
950 N 1800 EAST RD, SHELBYVILLE, IL 62565-4219
(217) 460-0931
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.020955
IL
Other
Enumeration date
02/13/2019
Last updated
02/13/2019
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