ANDREA TACK

ROCKFORD, IL
NPI1447706296
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy104100000X Social Worker
(Licence: IL  150.015410)
Enumeration Date2016-08-31
Last Update Date2017-06-30
Business Address
-- ANDREA TACK
3690 LAURA LN
ROCKFORD, IL 61114-8179
Phone number: 815-520-4145
Mailing Address
-- ANDREA TACK
123456 MAIN STREET
ROCKFORD, IL 61114-8179
Phone number:
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