Individual
MS. SUE HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4201 N MULFORD RD, LOVES PARK, IL 61111-6953
(815) 713-9868
Mailing address
4201 N MULFORD RD, LOVES PARK, IL 61111-6953
(815) 713-9868
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227003268
IL
Other
Enumeration date
09/08/2014
Last updated
09/08/2014
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