Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251E1200X | Ergonomics | 070015607 | IL |
N | 225XE1200X | Ergonomics | 070015607 | IL |
N | 2251G0304X | Physical Therapist - Geriatrics | 070015607 | IL |
N | 2251S0007X | Physical Therapist - Sports | 070015607 | IL |
Y | 2251X0800X | Physical Therapist - Orthopedic | 070015607 | IL |
N | 225700000X | Massage Therapist | 227001920 | IL |
NPI | 1962678052 |
---|---|
Provider Name | Lance Labno |
First Address | Evanston, IL 60201-1839 |
Second Address | Wilmette, IL 60091-2843 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2008 |
Last Update Date | 02/08/2012 |