Individual
MS. ROSEANNE PONTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSOM, L.AC.,BS
Contact information
Practice address
3306 ROYAL WOODS DR, CRYSTAL LAKE, IL 60014-4793
(847) 602-2114
Mailing address
3306 ROYAL WOODS DR, CRYSTAL LAKE, IL 60014-4793
(847) 602-2114
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
198.011005
IL
171100000X
Acupuncturist
728-055
WI
Other
Enumeration date
01/28/2013
Last updated
01/28/2013
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