Individual
JESSICA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2046 JONATHAN CREEK RD, ARTHUR, IL 61911-6108
(217) 962-0614
Mailing address
808 S DON RYAN ST, HAMMOND, IL 61929-7219
(217) 259-5450
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.020428
IL
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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