Individual
TONYA LYSHONNA BALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7718 S CORNELL AVE FL 2, CHICAGO, IL 60649-4510
(573) 528-9260
Mailing address
7718 S CORNELL AVE FL 2, CHICAGO, IL 60649-4510
(573) 528-9260
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.019064
IL
Other
Enumeration date
02/22/2020
Last updated
02/22/2020
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