SearchIllinois171100000X

Star Gravette, L.AC

NPI 1649495185 · on the registry since 2007 · sole proprietor

Practice

Address
1463 Cantwell Ln Apt 8
Swansea, IL 62226
Phone
(618) 416-1557

Registry record

Primary taxonomy
171100000X
171100000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2007-07-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois