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1740541226
EILEEN JANIS LACKI
ST PETERSBURG, FL
NPI
1740541226
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Former Name
EILEEN JANIS O'BRIEN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: FL PTA18384)
Enumeration Date
2012-05-31
Last Update Date
2012-05-31
Business Address
MRS. EILEEN JANIS LACKI PTA
5535 PARK ST N
ST PETERSBURG, FL 33709-6309
Phone number: 727-209-0579
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Mailing Address
MRS. EILEEN JANIS LACKI PTA
6447 FAIRWAY VIEW BLVD S
ST PETERSBURG, FL 33707-3815
Phone number: 727-209-0579
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