EMILY LAKE PTA
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1952910234- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PTA
- Status
- Active
Contact & Location
- Address
- 1411 S CREASY LN STE 100, LAFAYETTE, IN, 479057433
- Phone
- (765) 447-5552
- Fax
- (765) 449-1054
Specialties & Taxonomies
Physical Therapy Assistant
License: IN #06006130A
Physical Therapy Assistant
Primary License: CA #53781