Individual
MR. PHILLIP MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1408 BURKE LN, SOUTH ELGIN, IL 60177-3054
(847) 630-8836
Mailing address
1408 BURKE LN, SOUTH ELGIN, IL 60177-3054
(847) 630-8836
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227009699
IL
Other
Enumeration date
08/28/2010
Last updated
08/28/2010
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