Individual
MISS IRIS NICHOLE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9201 S DREXEL AVE, CHICAGO, IL 60619-7724
(773) 754-9242
Mailing address
9201 S DREXEL AVE, CHICAGO, IL 60619-7724
(773) 754-9242
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227012364
IL
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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