Individual
PAUL EUBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
443 FINCH DR, ROUND LAKE, IL 60073-9558
(773) 316-6775
Mailing address
443 FINCH DR, ROUND LAKE, IL 60073-9558
(773) 316-6775
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.008655
IL
225700000X
Massage Therapist
4988-146
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
227.008655
MASSAGE THERAPIST
IL
01
—
4988-146
MASSAGE THERAPIST
WI
Enumeration date
12/20/2011
Last updated
12/20/2011
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