Individual
MISS JEANNETTA ANJALA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1314 W 15TH ST APT 608, CHICAGO, IL 60608-4661
(773) 876-6954
Mailing address
1314 W 15TH ST APT 608, CHICAGO, IL 60608-4661
(773) 876-6954
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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