Individual
LUCIA NICHOLE REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, BCTMB
Contact information
Practice address
2606 BROADWAY, ROCKFORD, IL 61108-5768
(815) 397-3744
Mailing address
1210 COLONIAL DR, MACHESNEY PARK, IL 61115-3808
(815) 560-2862
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
220.014395
IL
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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