Individual
JOYCE DETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4007 N BROADWAY ST, 204, CHICAGO, IL 60613-6074
(773) 678-4002
Mailing address
824 W CUYLER AVE, 332, CHICAGO, IL 60613-3281
(773) 678-4002
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227006915
IL
Other
Enumeration date
04/20/2012
Last updated
04/20/2012
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