Individual
LAUREN JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7060 HIGHLAND DRIVE, PITTSBURGH, PA 15206
(412) 655-6746
Mailing address
PO BOX 870, 403 SIXTH STREET, HUNTINGDON, PA 16652
(814) 506-8212
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC012500
PA
Other
Enumeration date
09/18/2012
Last updated
09/19/2012
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