Organization
WILMER LACSON REHAB SERVICES,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILMER AVANCY LACSON (PRESIDENT/OWNER)
(917) 484-1465
Entity
Organization
Contact information
Practice address
66 CRISFIELD ST, UNIT 1Q, YONKERS, NY 10710-1243
(917) 484-1465
Mailing address
315 E 108TH ST, APT 2C, NEW YORK, NY 10029-4245
(917) 484-1465
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
0157731
NY
Other
Enumeration date
06/01/2016
Last updated
06/01/2016
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