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General NPI Number Information
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NPI Number | 1962678052
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Entity Type | Individual
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Provider Name | LANCE LABNO P.T.
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Gender | Male
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 08/02/2012
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Provider Practice Location Address
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Address Line | 350 LINDEN AVE
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City | WILMETTE
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State | IL
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Zip | 60091-2843
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Country | US
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Telephone | 847-372-3816
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Fax |
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Provider Business Mailing Address
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Address Line | 2441 PROSPECT AVE
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City | EVANSTON
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State | IL
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Zip | 60201-1839
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Country | US
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Telephone | 847-372-3816
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 070015607
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 227001920
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 070015607
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 070015607
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 2251E1200X
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Taxonomy Name | Ergonomics Physical Therapist
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License Number | 070015607
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License Number State | IL
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