STACEY MARIE LANE

CHICAGO, IL
NPI1497065007
Former NameSTACEY MARIE REIMER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: IL  070018155)
Enumeration Date2010-10-15
Last Update Date2010-10-15
Business Address
-- STACEY MARIE LANE DPT
345 E SUPERIOR ST
CHICAGO, IL 60611-2654
Phone number: 312-238-1000
Mailing Address
-- STACEY MARIE LANE DPT
1115 MISTWOOD LN
DOWNERS GROVE, IL 60515-1215
Phone number:
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