Individual
LAURA K LASATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
300 S BROADWAY AVE # 155B, URBANA, IL 61801-3449
(217) 344-9144
Mailing address
300 S BROADWAY AVE #155B, URBANA, IL 61801-3449
(217) 344-9144
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227002150
IL
Other
Enumeration date
09/27/2023
Last updated
09/27/2023
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