JEFFERSON JAMES MAHINAY LICUP

BOLINGBROOK, IL
NPI1437484110
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: IL  056007185)
Enumeration Date2009-10-13
Last Update Date2009-10-13
Business Address
Mr. JEFFERSON JAMES MAHINAY LICUP OTR/L
226 TIGER ST
BOLINGBROOK, IL 60490-2053
Phone number: 708-822-8886
Mailing Address
Mr. JEFFERSON JAMES MAHINAY LICUP OTR/L
226 TIGER ST
BOLINGBROOK, IL 60490-2053
Phone number: 708-822-8886
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