Individual
MR. MARK W LAVRACK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
111 S MICHIGAN AVE APT 101, GAYLORD, MI 49735-2724
(989) 213-3932
Mailing address
111 S MICHIGAN AVE APT 101, GAYLORD, MI 49735-2724
(989) 213-3932
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005718
MI
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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