Individual
ROYCE MICHEAL DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT, MMP
Contact information
Practice address
703 DODGE AVE APT 2N, EVANSTON, IL 60202-1975
(773) 289-6212
Mailing address
703 DODGE AVE APT 2N, EVANSTON, IL 60202-1975
(773) 289-6212
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227010167
IL
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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