Individual
MISS HEIDI JOLENE GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
319 DEMPSTER ST, SUITE 208, EVANSTON, IL 60201-4797
(847) 733-0169
Mailing address
4183 N CLARENDON AVE, SUITE 12, CHICAGO, IL 60613-2460
(773) 517-2588
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
IL
Other
Enumeration date
02/25/2008
Last updated
02/25/2008
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