Individual
JOHN LICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
301 LONG RAPIDS RD, ALPENA, MI 49707-1317
(989) 356-2194
Mailing address
111 W MICHIGAN ST, MILWAUKEE, WI 53203-2903
(800) 395-5000
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
L22574440
MI
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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