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Individual

ALISA VALE WASZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
14730 MAIN ST, HARVEY, IL 60426-1923
(708) 333-1390
Mailing address
510 LAKE SOMMERVILLE TRL, GEORGETOWN, TX 78633-5269
(219) 614-7772

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.001251
IL

Other

Enumeration date
05/08/2020
Last updated
05/08/2020
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