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1205476645
JERRY HENLEY
CHICAGO, IL
NPI
1205476645
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2020-01-14
Last Update Date
2020-01-14
Business Address
JERRY HENLEY LATC
322 N LEAVITT ST UNIT B
CHICAGO, IL 60612-1616
Phone number: 312-307-1813
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Mailing Address
JERRY HENLEY LATC
825 W 59TH ST
LA GRANGE HIGHLANDS, IL 60525-7411
Phone number: 312-307-1813
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