Individual
JODY S HESTAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
801 W DEYOUNG ST STE C, MARION, IL 62959-1649
(417) 312-1645
Mailing address
801 W DEYOUNG ST STE C, MARION, IL 62959-1649
(417) 312-1645
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227021192
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227.021192
LICENSED MASSAGE THERAPIST
IL
Enumeration date
04/20/2021
Last updated
04/20/2021
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