Individual
MISS LORI ANN MACKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1548 SANS SOUCI PKWY, HANOVER TOWNSHIP, PA 18706-6028
(570) 825-8725
Mailing address
396 SCHWABE ST, FREELAND, PA 18224-1218
(570) 636-2012
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE007045
PA
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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