Individual
JILL LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
201 GRAND AVE, WASHINGTON, MO 63090-1209
(636) 239-9190
Mailing address
836 RAVENSRIDGE RD, A1, SAINT LOUIS, MO 63119-5531
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2013028655
MO
Other
Enumeration date
10/04/2013
Last updated
10/04/2013
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