Individual
IAN DUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
3407 S STATE ROUTE 157, GLEN CARBON, IL 62034-1042
(618) 288-3610
Mailing address
3407 S STATE ROUTE 157, GLEN CARBON, IL 62034-1042
(618) 288-3610
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
222.001977
IL
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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