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Individual

TINA ADLAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.T.

Contact information

Practice address
3329 VOLLMER RD, FLOSSMOOR, IL 60422-2003
(708) 206-2750
Mailing address
582 RANGER DR, CHICAGO HEIGHTS, IL 60411-1911
(708) 205-5185

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227015353
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
227015353
STATE LICENSE
IL
Enumeration date
03/29/2013
Last updated
03/29/2013
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