Individual
MS. LISA M KRISTOFFERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
11 S LAKE ST # 3, GRAYSLAKE, IL 60030-1511
(847) 693-1515
Mailing address
11 S LAKE ST # 3, GRAYSLAKE, IL 60030-1511
(847) 693-1515
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.010659
IL
Other
Enumeration date
09/10/2013
Last updated
09/10/2013
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