Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 227009241 | IL |
NPI | 1003050741 |
---|---|
Provider Name | Laura Christin Paluch |
First Address | Elgin, IL 60120-5587 |
Second Address | Elgin, IL 60120-5587 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2009 |
Last Update Date | 24/04/2009 |