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Individual

RUSTIE MARIE NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2800 MONTALUMA DR, SPRINGFIELD, IL 62704-6900
(309) 333-4678
Mailing address
5 CANDLETREE DR APT 8, SPRINGFIELD, IL 62704-8036
(309) 333-4678

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.020805
IL

Other

Enumeration date
03/07/2025
Last updated
03/07/2025
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