Individual
LORRI LYNN ILCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 954-7408
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 954-7408
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7492
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7492
PHYSICAL THERAPIST
TN
Enumeration date
01/30/2014
Last updated
01/30/2014
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