Individual
MS. JACQUELINE ADELE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
1048 SPINNAKER ST, ELGIN, IL 60123-8587
(224) 628-2716
Mailing address
1048 SPINNAKER ST, ELGIN, IL 60123-8587
(224) 628-2716
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227005797
IL
Other
Enumeration date
11/06/2012
Last updated
11/06/2012
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