Individual
JESSE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
13100 GREENWOOD AVE, BLUE ISLAND, IL 60406-2308
(847) 532-3111
Mailing address
13100 GREENWOOD AVE, BLUE ISLAND, IL 60406-2308
(847) 532-3111
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227017843
IL
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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