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Individual

MR. JEROME ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
15700 INGLESIDE AVE, DOLTON, IL 60419-2764
(773) 383-8813
Mailing address
15700 INGLESIDE AVE, DOLTON, IL 60419-2764
(773) 383-8813

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227.020129
IL

Other

Enumeration date
01/14/2025
Last updated
01/14/2025
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