CHANCELOR LUCAS HERNANDEZ

BEAVER DAM, WI
NPI1336529296
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WI  1063-39)
Enumeration Date2015-06-05
Last Update Date2015-06-05
Business Address
-- CHANCELOR LUCAS HERNANDEZ MA, ATC, LAT
707 S UNIVERSITY AVE
BEAVER DAM, WI 53916-3027
Phone number: 920-219-4009
Mailing Address
-- CHANCELOR LUCAS HERNANDEZ MA, ATC, LAT
207 MONROE ST APT 9
BEAVER DAM, WI 53916-2475
Phone number: 920-382-7313
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