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1205528882
SHANE LANTZ
JUNEAU, AK
NPI
1205528882
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-05-23
Last Update Date
2023-05-23
Business Address
Mr. SHANE LANTZ
5597 AISEK ST
JUNEAU, AK 99801-9522
Phone number: 907-780-3042
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Mailing Address
Mr. SHANE LANTZ
5597 AISEK ST
JUNEAU, AK 99801-9522
Phone number: 907-780-3044
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