Individual
MR. JEREMY PAUL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, LAC
Contact information
Practice address
1500 W FARWELL AVE APT 3, CHICAGO, IL 60626-3666
(828) 773-4739
Mailing address
1500 W FARWELL AVE APT 3, CHICAGO, IL 60626-3666
(828) 773-4739
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198001498
IL
225700000X
Massage Therapist
227016825
IL
Other
Enumeration date
10/25/2019
Last updated
10/25/2019
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