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1922728047
JASON ROOSEVELT BRUSA
CHICAGO, IL
NPI
1922728047
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225800000X Recreation Therapist
(Licence: IL 56129)
Enumeration Date
2022-08-30
Last Update Date
2022-08-30
Business Address
JASON ROOSEVELT BRUSA
820 S DAMEN AVE
CHICAGO, IL 60612-3728
Phone number: 312-569-9502
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Mailing Address
JASON ROOSEVELT BRUSA
902 CLEMENT ST
JOLIET, IL 60435-4615
Phone number: 630-698-0214
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