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Individual

KEISHA SHAVONNE JACKSON-MURRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
812 GLADSTONE DR, VERNON HILLS, IL 60061-1406
(847) 644-6920
Mailing address
812 GLADSTONE DR, VERNON HILLS, IL 60061-1406
(847) 644-6920

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary

Other

Enumeration date
03/11/2019
Last updated
03/11/2019
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