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1003037821
LANCE AVON MICHEL
MESA, AZ
NPI
1003037821
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: AZ 0063)
Enumeration Date
2007-05-01
Last Update Date
2007-07-08
Business Address
LANCE AVON MICHEL ATC
2506 S SORRELLE
MESA, AZ 85209
Phone number: 480-985-5722
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Mailing Address
LANCE AVON MICHEL ATC
2506 S SORRELLE
MESA, AZ 85209
Phone number: 480-985-5722
Copy
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