Individual
MRS. LAURA C LILAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1700 TIBBITS AVE, TROY, NY 12180-3726
(518) 328-5801
(518) 274-0371
Mailing address
8 SAGE LN, FORT EDWARD, NY 12828-2486
(518) 366-7438
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
015497
NY
2251P0200X
Pediatric Physical Therapist
Primary
015497
NY
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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