Individual
MS. JESSICA S LANIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1600 ROCKLAND RD, WILMINGTON, DE 19803-3607
(302) 298-7768
Mailing address
1727 RIDGEWAY RD, HAVERTOWN, PA 19083-1613
(610) 761-7678
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017440
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LA1764189
BC/BS PROVIDER #
PA
Enumeration date
04/18/2006
Last updated
10/27/2016
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