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1285866111
TELISA LONG
PARK FOREST, IL
NPI
1285866111
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
347C00000X Private Vehicle
(Licence: IL l52081680690)
Enumeration Date
2009-08-11
Last Update Date
2009-08-11
Business Address
Ms. TELISA LONG
413 INDIANWOOD BLVD
PARK FOREST, IL 60466-2247
Phone number: 708-369-2368
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Mailing Address
Ms. TELISA LONG
413 INDIANWOOD BLVD
PARK FOREST, IL 60466-2247
Phone number: 708-369-2368
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