Individual
MISS JOVONNA DIONNE MOXLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
424 W 117TH ST, CHICAGO, IL 60628-5302
(614) 579-9526
Mailing address
424 W 117TH ST, CHICAGO, IL 60628-5302
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
09/16/2009
Last updated
09/16/2009
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