Jon R Petersen L.M.T.

NPI 1396937330 - Massage Therapist - 225700000X

NPI Details
NPI 1396937330
Gender Male
Enumeration Date 08/14/2007
Last Updated 05/10/2010
Entity Type Individual
Active Over 9 years ago
Practice Location
1307 COURT ST
MCHENRY IL, 60050-4422, US
Phone (815) 385-8190
Fax
Business Location
1307 COURT ST
MCHENRY IL, 60050-4422, US
Phone (815) 385-8190
Fax
Toxanomy
Taxonomy Code 225700000X
License State Illinois
License Number 227-000243
Remove 1396937330 NPI Number
 

According to our database, Mr. Jon R Petersen L.M.T. NPI is 1396937330, taxonomy code is 225700000X and license number is 227-000243, license state is located at Illinois. Jon R Petersen L.M.T. physically located at 1307 Court St, Mchenry IL, 60050-4422. NPI Number Jon R Petersen L.M.T. has the Individual type.

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1396937330 NPI number is provided on an as is basis without warranty of any kind. 1396937330 is maintained by the National Plan & Provider Enumeration System. The contents of Jon R Petersen L.M.T. are for informational purposes only.