SEAN MARK LABASTIDA SUPERTICIOSO

CRYSTAL LAKE, IL
NPI1497217350
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: IL  070024159)
Enumeration Date2019-04-01
Last Update Date2019-04-01
Business Address
SEAN MARK LABASTIDA SUPERTICIOSO PT
1 S VIRGINIA ST
CRYSTAL LAKE, IL 60014-5828
Phone number: 815-356-9371
Mailing Address
SEAN MARK LABASTIDA SUPERTICIOSO PT
1 S VIRGINIA ST
CRYSTAL LAKE, IL 60014-5828
Phone number: 815-356-9371
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