KEVIN LACKE

BASTROP, TX
NPI1114575529
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: TX  1322490)
Enumeration Date2019-08-28
Last Update Date2021-04-30
Business Address
KEVIN LACKE DPT, CSCS
747 TEXAS 71 FRONTAGE RD SUITE B-200
BASTROP, TX 78602
Phone number: 512-920-6512
Mailing Address
KEVIN LACKE DPT, CSCS
6611 ZEQUIEL DR
AUSTIN, TX 78744-7231
Phone number: 508-446-1756