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Gwenetta J Dickerson
Massage Therapist in Collinsville, Illinois
NPI 1730681800

Gwenetta J Dickerson is a Massage Therapist based in Collinsville, IL. Gwenetta J Dickerson practices in Collinsville, IL. The NPI Number for Gwenetta J Dickerson is 1730681800 and holds a License No. 227018739 (Illinois).

The current practice location address for Gwenetta J Dickerson is 100 Eagle Crk, Collinsville, IL and can be reached out via phone at 314-933-6369.

Location: 100 Eagle Crk, Collinsville, IL, 62234-4395
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730681800
Provider Name
Gwenetta J Dickerson
Credential
Provider Entity Type
Individual
Gender
Female
Address
100 Eagle Crk, Collinsville, IL, 62234-4395
Phone Number
314-933-6369
Fax Number
Provider Enumeration Date
03/05/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
100 Eagle Crk
City
Collinsville
State
Illinois
Zip
62234-4395
Phone Number
314-933-6369
Fax Number
person
Provider Business Mailing Address Details
Address
100 Eagle Crk
City
Collinsville
State
Illinois
Zip
62234-4395
Phone Number
314-933-6369
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
227018739 (Illinois)
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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