Individual
CHANDREE OLIVA LACANLALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1624 S ROUTE 59, NAPERVILLE, IL 60564-5966
(331) 248-4088
(331) 330-2759
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
(914) 294-4050
(631) 760-8306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070027835
IL
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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