Brett Lark

NPI 1265792758 - Physical Therapist - 225100000X

NPI Details
NPI 1265792758
Gender Male
Enumeration Date 05/18/2012
Last Updated 05/18/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
2401 RAVINE WAY
SUITE 100
GLENVIEW IL, 60025-7645, US
Phone (847) 724-4791
Fax
Business Location
8930 WAUKEGAN RD
SUITE 200
MORTON GROVE IL, 60053-2126, US
Phone (847) 324-3976
Fax
Toxanomy
Taxonomy Code 225100000X
License State
License Number
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According to our database, Brett Lark NPI is 1265792758, taxonomy code is 225100000X Brett Lark physically located at 2401 Ravine Way, Glenview IL, 60025-7645. NPI Number Brett Lark has the Individual type.

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1265792758 NPI number is provided on an as is basis without warranty of any kind. 1265792758 is maintained by the National Plan & Provider Enumeration System. The contents of Brett Lark are for informational purposes only.