Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist |
NPI | 1013503499 |
---|---|
Provider Name | Gina Migasi |
First Address | Park Ridge, IL 60068-4446 |
Second Address | Winnetka, IL 60093-2518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2020 |
Last Update Date | 18/12/2020 |