Individual
LISA MICHELLE PACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7429
Mailing address
840 E FERGUSON AVE, WOOD RIVER, IL 62095-2150
(618) 251-4369
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.001959
IL
Other
Enumeration date
05/11/2011
Last updated
05/11/2011
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