MRS. Jamie Lynn Fanara, JAMIE FANARA, LCMT

NPI #1174813398 in Rockford, Illinois

Provider Information

NPI Number: 1174813398
Entity Type: Individual
Name: MRS. Jamie Lynn Fanara, JAMIE FANARA, LCMT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Credential: JAMIE FANARA, LCMT
Enumeration Date: Apr 8, 2011
Last Updated: Apr 8, 2011

Practice Location

Address: 461 N. MULFORD ROAD
Address 2: UNIT 8
City: Rockford
State: Illinois
ZIP Code: 61107
Phone: (815) 977-4743

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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