Individual
LISA GASAWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1021 W E ST, BELLEVILLE, IL 62220-1055
(618) 233-2095
Mailing address
1564 ERICA RENEE CT, BELLEVILLE, IL 62220-3257
(618) 484-8301
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.009792
IL
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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