Individual
JASMINE MAZIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1122 HOUBOLT RD, JOLIET, IL 60431-9063
(779) 260-2700
(779) 260-2701
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258
(586) 305-2644
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.009890
IL
Other
Enumeration date
06/06/2022
Last updated
10/11/2024
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