Individual
MAYLA M JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1305 N CAROLYN DR, MINONK, IL 61760-9326
(309) 432-3451
(309) 432-3625
Mailing address
122 SAINT JAMES PL, PONTIAC, IL 61764-2126
(815) 579-8077
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
049191444
IL
Other
Enumeration date
12/02/2021
Last updated
12/02/2021
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