Individual
CAROLYN REBECCA LACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
147 W 24TH ST, 7TH FLOOR, NEW YORK, NY 10011-1911
(212) 997-7490
(212) 997-7492
Mailing address
50 LEXINGTON AVE, APT 24A, NEW YORK, NY 10010-2935
(212) 674-3231
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
025886-1
NY
Other
Enumeration date
06/11/2008
Last updated
03/13/2017
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