Individual
MRS. CHARISMA LARIOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3724 N RUTHERFORD AVE, CHICAGO, IL 60634-2392
(773) 698-5584
(708) 776-7816
Mailing address
3724 N RUTHERFORD AVE, CHICAGO, IL 60634-2392
(773) 698-5584
(708) 776-7816
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070012507
IL
Other
Enumeration date
10/07/2019
Last updated
10/07/2019
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