Individual
ALICIA M LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
115 EAST BROADWAY, ASHLAND, MO 65010
(573) 657-1915
(573) 657-1875
Mailing address
3301 BERRYWOOD DR, SUITE 204, COLUMBIA, MO 65201-6517
(573) 449-8771
(573) 449-6563
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
108118
MO
2255A2300X
Athletic Trainer
105861
MO
Other
Enumeration date
07/17/2006
Last updated
03/18/2015
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