Individual
LISA PODLECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
207 MERCHANTS WALK, SUMMERSVILLE, WV 26651-1901
(048) 727-4983
Mailing address
PO BOX 494, MOUNT LOOKOUT, WV 26678-0494
(303) 903-7061
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004303
WV
Other
Enumeration date
08/30/2018
Last updated
10/03/2020
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