Individual
EMILY MARIE CLAYCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
13936 STATE HIGHWAY 97, PETERSBURG, IL 62675-6094
(217) 502-1181
Mailing address
13936 STATE HIGHWAY 97, PETERSBURG, IL 62675-6094
(217) 502-1181
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.021172
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227.021172
LMT
IL
Enumeration date
03/02/2023
Last updated
03/02/2023
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