Individual
MRS. EMILY SUZANNE KNOLLENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2309 W WHITE OAKS DR, SUITE C, SPRINGFIELD, IL 62704-7421
(217) 553-3061
Mailing address
2309 W WHITE OAKS DR, SUITE C, SPRINGFIELD, IL 62704-7421
(217) 553-3061
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227004085
IL
Other
Enumeration date
08/23/2010
Last updated
08/23/2010
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