Individual
KELLY TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5 E WASHINGTON ST STE B, OSWEGO, IL 60543-8622
(815) 751-0758
Mailing address
390 KENSINGTON DR, OSWEGO, IL 60543-8318
(815) 751-0758
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227015935
IL
Other
Enumeration date
08/01/2014
Last updated
08/23/2024
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