Individual
CLINTON ROBERT LACKAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-6677
Mailing address
2919 S 45TH ST, MILWAUKEE, WI 53219-3413
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16034-24
WI
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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