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Individual

PENNY LYNNE WHEELER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
5944 MAIN ST, FROHNA, MO 63748-8128
(573) 824-5215
(573) 824-1109
Mailing address
5944 MAIN ST, P.O. BOX 82, FROHNA, MO 63748-8128
(573) 824-5215
(573) 824-1109

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2011039605
MO

Other

Enumeration date
06/21/2012
Last updated
06/21/2012
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