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Individual

JENNIFER LYNN DICKENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
260 S MAIN ST, SENECA, IL 61360-9414
(815) 357-6858
(815) 357-6857
Mailing address
570 LOGUE CIR, SENECA, IL 61360-9671
(815) 954-3818

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.009909
IL

Other

Enumeration date
08/09/2012
Last updated
08/09/2012
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