Individual
STACEY LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
787 N DETROIT ST, LAGRANGE, IN 46761-1111
(260) 463-2172
Mailing address
787 N DETROIT ST, LAGRANGE, IN 46761-1111
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009110A
IN
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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