NPI 1790900686

Angel V Genereau, LMT

Practitioner Massage Therapist La Grange, IL

Practice location

Address: 7273 Flagg Creek Dr, La Grange, IL 60525-5307
Phone: (312) 953-1424
Fax: (866) 483-0652

Registered specialties (2)

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 227004283 (IL)

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Mechanotherapist

Other Service Providers Taxonomy 172M00000X Licence 227004283 (IL)

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Registry record

NPI: 1790900686
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Apr 2007
Record last updated: 16 Jul 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.