Individual
STACI BAKERPRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
105 1/2 W WALNUT ST, OGLESBY, IL 61348-1215
(815) 228-0438
Mailing address
105 1/2 W WALNUT ST, OGLESBY, IL 61348-1215
(815) 228-0438
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
01/08/2021
Last updated
01/08/2021
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