Individual
LISA LEANN RACINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
800 E OHIO ST, JASONVILLE, IN 47438-1607
(812) 665-2226
Mailing address
18 N EDWARDS ST, WORTHINGTON, IN 47471-1305
(812) 699-0320
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005216A
IN
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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