Individual provider · Type 1 NPI

Gwenn None Marie, BCPP, BCTMB, LMT

Massage Therapist · Bloomington, IL

NPI number 1164043113 Active

Practice location

2416 E Washington St Ste A9
Bloomington, IL 61704-1612

Call (309) 310-6472 Map

Mailing address

13 Broadway Pl
Normal, IL 61761-3620

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X227.001257 (IL)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1164043113

Gwenn None Marie, BCPP, BCTMB, LMT's National Provider Identifier is 1164043113, issued on Apr 30, 2020. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Bloomington, IL. The record was last updated on Apr 30, 2020.