Individual
MALLORY KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2211 WAUKEGAN RD, BANNOCKBURN, IL 60015-1570
(847) 267-8600
(847) 267-9520
Mailing address
2211 WAUKEGAN RD, BANNOCKBURN, IL 60015-1570
(847) 267-8600
(847) 267-9520
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227012722
IL
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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