Lack, Ashley

Lack, Ashley is an individual health care provider with primary practice located at 20 Junction Dr W Ste 4 , Glen Carbon IL 62034-3060. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Lack, Ashley can be contacted via phone (618) 288-8020.

Contact Information

Primary practice address
20 Junction Dr W Ste 4 Glen Carbon IL 62034-3060
Phone: (618) 288-8020
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 2009034462 Missouri
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070.019121 Illinois

Profile Details

NPI number 1245896836
LBN Legal business name Lack, Ashley
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2019
Last updated Jun 26th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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