Wheeler, Lacrisha Nicole

Wheeler, Lacrisha Nicole is an individual health care provider with primary practice located at 1401 E State St , Rockford IL 61104-2315. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Wheeler, Lacrisha Nicole can be contacted via phone (815) 489-4470.

Contact Information

Primary practice address
1401 E State St Rockford IL 61104-2315
Phone: (815) 489-4470
Fax: (815) 490-5858
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X Illinois

Profile Details

NPI number 1780802074
LBN Legal business name Wheeler, Lacrisha Nicole
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2007
Last updated Jul 8th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1780802074 NPPES
Illinois Other LW06011204A EI CREDENTIAL NUMBER

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