Individual
DENEACE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, MMT
Contact information
Practice address
845 N MICHIGAN AVE, STE 922 EAST, CHICAGO, IL 60611-2252
(773) 844-1475
Mailing address
2945 W GREGORY ST, CHICAGO, IL 60625-3911
(773) 844-1475
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.002625
IL
374J00000X
Doula
—
—
Other
Enumeration date
06/21/2012
Last updated
03/03/2015
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