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1447014139
JESSICA AINSWORTH BLACK
CARBONDALE, IL
NPI
1447014139
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
(Licence: IL 227.013773)
Enumeration Date
2024-02-12
Last Update Date
2024-02-12
Business Address
JESSICA AINSWORTH BLACK LMT
2031 S ILLINOIS AVE
CARBONDALE, IL 62903-5909
Phone number: 618-457-7732
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Mailing Address
JESSICA AINSWORTH BLACK LMT
53 LAKESIDE DR
MAKANDA, IL 62958-2639
Phone number: 217-972-8259
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