Individual
TRISTAN DOUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
131 KELLER AVE, WAUKEGAN, IL 60085
(847) 623-0339
Mailing address
131 KELLER AVE, WAUKEGAN, IL 60085-5003
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.007036
IL
Other
Enumeration date
04/19/2010
Last updated
01/20/2011
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