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1245619204
JESSICA FULGENCIO
ORLAND PARK, IL
NPI
1245619204
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IL 160006542)
Enumeration Date
2015-05-23
Last Update Date
2015-05-23
Business Address
-- JESSICA FULGENCIO
16170 KINGSPORT RD
ORLAND PARK, IL 60467-5602
Phone number: 708-326-1550
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Mailing Address
-- JESSICA FULGENCIO
5636 W 35TH ST APT 6
CICERO, IL 60804-4333
Phone number: 708-374-3882
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