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Individual

NICOLE TELLEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
490 LAKE ST, ROSELLE, IL 60172-3583
Mailing address
PO BOX 544, ADDISON, IL 60101-0544

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227016162
IL

Other

Enumeration date
05/31/2017
Last updated
05/31/2017
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