Individual
MISS JENNA M FULKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
997 N CORPORATE CIR STE B, GRAYSLAKE, IL 60030-7822
(847) 223-8001
(847) 986-3580
Mailing address
997 N CORPORATE CIR STE B, GRAYSLAKE, IL 60030-7822
(847) 223-8001
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
070.026739
IL
Other
Enumeration date
07/28/2022
Last updated
07/28/2022
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