Individual
LAUREN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
197 S MONTEREY AVE, ELMHURST, IL 60126-3006
(630) 453-1136
Mailing address
197 S MONTEREY AVE, ELMHURST, IL 60126-3006
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227016980
IL
Other
Enumeration date
07/09/2014
Last updated
07/09/2014
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