Individual
MRS. LOLA HERNDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
844 WILSHIRE DR, BELLEVILLE, IL 62223-2623
(314) 380-4202
Mailing address
844 WILSHIRE DR, BELLEVILLE, IL 62223-2623
(314) 380-4202
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2014031513
MO
Other
Enumeration date
10/22/2020
Last updated
11/10/2020
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