Individual
ALEXANDRA LAINE JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1977 DEWAR DR STE J, ROCK SPRINGS, WY 82901-5757
(307) 382-3228
(307) 382-6886
Mailing address
1977 DEWAR DR STE J, ROCK SPRINGS, WY 82901-5757
(307) 382-3228
(307) 382-6886
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1313
WY
Other
Enumeration date
06/23/2010
Last updated
06/23/2010
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