Individual
JOVAN PLUNKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4019 183RD ST, COUNTRY CLUB HILLS, IL 60478-5306
(708) 573-2963
Mailing address
710 BRADLEY AVE, MATTESON, IL 60443-1605
(708) 573-2963
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.020475
IL
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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