Theresa Rose Stark L.M.T

NPI 1275774788 - Massage Therapist - 225700000X

NPI Details
NPI 1275774788
Gender Female
Enumeration Date 03/12/2009
Last Updated 03/12/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
633 S PLYMOUTH CT
CHICAGO IL, 60605-1845, US
Phone (773) 742-9715
Fax
Business Location
6540 S KEDVALE AVE
CHICAGO IL, 60629-5111, US
Phone (773) 742-9715
Fax
Toxanomy
Taxonomy Code 225700000X
License State Illinois
License Number 227-008050
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According to our database, Ms. Theresa Rose Stark L.M.T NPI is 1275774788, taxonomy code is 225700000X and license number is 227-008050, license state is located at Illinois. Theresa Rose Stark L.M.T physically located at 633 S Plymouth Ct, Chicago IL, 60605-1845. NPI Number Theresa Rose Stark L.M.T has the Individual type.

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1275774788 NPI number is provided on an as is basis without warranty of any kind. 1275774788 is maintained by the National Plan & Provider Enumeration System. The contents of Theresa Rose Stark L.M.T are for informational purposes only.