Ashley Lack, MPT

NPI #1245896836 in Glen Carbon, Illinois

Provider Information

NPI Number: 1245896836
Entity Type: Individual
Name: Ashley Lack, MPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: MPT
Enumeration Date: May 19, 2019
Last Updated: Jun 26, 2020

Practice Location

Address: 20 JUNCTION DR W STE 4
City: Glen Carbon
State: Illinois
ZIP Code: 62034-3060
Phone: (618) 288-8020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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