Individual
JACQUELINE MARGARET JOHNSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1113 S MILWAUKEE AVE, SUITE 201, LIBERTYVILLE, IL 60048-3758
(847) 693-9775
Mailing address
232 STATION PARK CIR, GRAYSLAKE, IL 60030-2468
(847) 693-9775
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227-012005
IL
Other
Enumeration date
03/17/2017
Last updated
03/17/2017
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