Individual
STAR C. GRAVETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
1463 CANTWELL LN APT 8, SWANSEA, IL 62226-2164
(618) 416-1557
Mailing address
1463 CANTWELL LN APT 8, SWANSEA, IL 62226-2164
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
IL
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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