Individual
JEROMY LEE PELLEGRINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
180 MAIN ST., BRAIDWOOD, IL 60408
(815) 458-2225
Mailing address
180 MAIN ST., BRAIDWOOD, IL 60408
(815) 458-2225
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.011716
IL
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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