Individual
MR. ANDREW S LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1215 N ALPINE RD, ROCKFORD, IL 61107-2201
(815) 391-7800
Mailing address
520 OAK KNOLLS AVE, ROCKFORD, IL 61107-4640
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.017898
IL
Other
Enumeration date
12/28/2010
Last updated
12/28/2010
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