Individual
MS. LOIS JANE HERTOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8060 KNUE RD, SUITE 110, INDIANAPOLIS, IN 46250
(800) 862-3310
(317) 842-7674
Mailing address
108 MARAJEAN AVE, NEW ALBANY, IN 47150
(812) 945-1878
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002085A
IN
225200000X
Physical Therapy Assistant
PTAA01151
KY
Other
Enumeration date
09/20/2007
Last updated
09/20/2007
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