Individual
JILL ST JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN LMT
Contact information
Practice address
15 E 6TH ST, OSWEGO, NY 13126-1143
(315) 887-0013
Mailing address
15 E 6TH ST, OSWEGO, NY 13126-1143
(315) 887-0013
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
519427
NY
225700000X
Massage Therapist
Primary
025463
NY
Other
Enumeration date
03/23/2014
Last updated
03/23/2014
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