Individual
ROBERTA DEARTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25652 W COLLEEN CT, CHANNAHON, IL 60410-8638
(815) 791-1510
(815) 886-5983
Mailing address
25652 W COLLEEN CT, CHANNAHON, IL 60410-8638
(815) 791-1510
(815) 886-5983
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227008582
IL
Other
Enumeration date
01/22/2010
Last updated
01/22/2010
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