| NPI | 1073169777 |
|---|---|
| Other Name | LAKEFRONT PT LLC |
| Entity Type | Organization |
| Authorized Contact | BILL R HITCHCOCK Member 765-744-6354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2019-08-18 |
| Last Update Date | 2020-04-30 |