Zach Lacross ATC

NPI 1013315092 - Specialist/Technologist - 2255A2300X

NPI Details
NPI 1013315092
Gender Male
Enumeration Date 12/08/2014
Last Updated 12/08/2014
Entity Type Individual
Active Over 1 year ago
Practice Location
1490 DOUGLAS DR
LINGLE HALL 118, MC 6620
CARBONDALE IL, 62901-4332, US
Phone (618) 453-4163
Fax (618) 453-4173
Business Location
1490 DOUGLAS DR
LINGLE HALL 118, MC 6620
CARBONDALE IL, 62901-4332, US
Phone (618) 453-4163
Fax (618) 453-4173
Toxanomy
Taxonomy Code 2255A2300X
License State Illinois
License Number 096.003415
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According to our database, Zach Lacross ATC NPI is 1013315092, taxonomy code is 2255A2300X and license number is 096.003415, license state is located at Illinois. Zach Lacross ATC physically located at 1490 Douglas Dr, Carbondale IL, 62901-4332. NPI Number Zach Lacross ATC has the Individual type.

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1013315092 NPI number is provided on an as is basis without warranty of any kind. 1013315092 is maintained by the National Plan & Provider Enumeration System. The contents of Zach Lacross ATC are for informational purposes only.