Individual
RENA LYNN FRAGALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5050 S LAKE SHORE DR, APT 915, CHICAGO, IL 60615-3282
(281) 838-2139
Mailing address
5050 S LAKE SHORE DR, APT 915, CHICAGO, IL 60615-3282
(281) 838-2139
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004844
IL
225200000X
Physical Therapy Assistant
2060433
TX
Other
Enumeration date
05/23/2007
Last updated
04/26/2016
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