Individual
MS. JAMIE JANINE WEISSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
510 E RIVERSIDE BLVD, LOVES PARK, IL 61111-4632
(815) 877-1910
Mailing address
4251 SHOREWOOD DR, ROCKFORD, IL 61101-9368
(815) 980-0477
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.001061
IL
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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