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1376092395
JASON LASOURCE
BIRMINGHAM, AL
NPI
1376092395
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: AL 1-129422)
Enumeration Date
2016-10-03
Last Update Date
2016-10-04
Business Address
Mr. JASON LASOURCE CRNA
810 SAINT VINCENTS DR
BIRMINGHAM, AL 35205-1601
Phone number: 205-939-7143
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Mailing Address
Mr. JASON LASOURCE CRNA
PO BOX 55310 BOX 111
BIRMINGHAM, AL 35255-5310
Phone number: 205-731-9701
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