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1568835189
LISA TACK
BOCA RATON, FL
NPI
1568835189
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: FL PA9109250)
Enumeration Date
2015-11-04
Last Update Date
2016-03-13
Business Address
-- LISA TACK PA-C
1001 NW 13TH ST #100
BOCA RATON, FL 33486-2269
Phone number: 561-750-0544
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Mailing Address
-- LISA TACK PA-C
1001 NW 13TH ST #100
BOCA RATON, FL 33486-2269
Phone number: 561-750-0544
Copy
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