The Legacy Ranch LLC

NPI #1063171445 in Lockport, Illinois

Provider Information

NPI Number: 1063171445
Entity Type: Organization
Organization Name: The Legacy Ranch LLC
Primary Specialty: Occupational Therapist
Enumeration Date: Dec 13, 2021
Last Updated: Dec 13, 2021

Practice Location

Address: 2705 S FARRELL RD
City: Lockport
State: Illinois
ZIP Code: 60441-9760
Phone: (630) 601-8920

Authorized Official

Name: SANDI MOLESKI
Title: OWNER
Phone: (630) 601-8920

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X
Speech-Language Pathologist	235Z00000X
Occupational Therapist	225X00000X	Primary

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