Individual
BRETT LARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 RAVINE WAY, SUITE 100, GLENVIEW, IL 60025-7645
(847) 724-4791
Mailing address
8930 WAUKEGAN RD, SUITE 200, MORTON GROVE, IL 60053-2126
(847) 324-3976
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/18/2012
Last updated
05/18/2012
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