Johneil Torena Juckett

NPI #1558505982 in Gages Lake, Illinois

Provider Information

NPI Number: 1558505982
Entity Type: Individual
Name: Johneil Torena Juckett
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Apr 29, 2009
Last Updated: Apr 29, 2009

Practice Location

Address: 33707 N LAKE SHORE DR
City: Gages Lake
State: Illinois
ZIP Code: 60030-1748
Phone: (847) 521-9559

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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