Individual
CHE' NICOLE LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1021 W E ST, BELLEVILLE, IL 62220-1055
(618) 233-2095
Mailing address
212 W SAINT CLAIR ST, FREEBURG, IL 62243-1136
(618) 402-4599
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.009013
IL
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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