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Ms. Carol Diane Boulware, LMT
Massage Therapist in Quincy, Illinois
NPI 1275781643

Carol Diane Boulware is a Massage Therapist based in Quincy, IL. Carol Diane Boulware practices in Quincy, IL and has the professional credentials of LMT. The NPI Number for Carol Diane Boulware is 1275781643 and holds a License No. 2005038798 (Illinois).

The current practice location address for Carol Diane Boulware is 1615 Spruce St, Quincy, IL and can be reached out via phone at 217-242-3495.

Location: 1615 Spruce St, Quincy, IL, 62301-2060
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1275781643
Provider Name
Carol Diane Boulware
Credential
LMT
Provider Entity Type
Individual
Gender
Female
Address
1615 Spruce St, Quincy, IL, 62301-2060
Phone Number
217-242-3495
Fax Number
Provider Enumeration Date
08/28/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1615 Spruce St
City
Quincy
State
Illinois
Zip
62301-2060
Phone Number
217-242-3495
Fax Number
person
Provider Business Mailing Address Details
Address
1615 Spruce St
City
Quincy
State
Illinois
Zip
62301-2060
Phone Number
217-242-3495
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
2005038798 (Missouri)
Definition
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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