JON CHARLES LACY

LOS ANGELES, CA
NPI1588907638
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: CA  pa22770)
Enumeration Date2013-03-27
Last Update Date2016-09-21
Business Address
Mr. JON CHARLES LACY PA
6368 HOLLYWOOD BLVD
LOS ANGELES, CA 90028-6320
Phone number: 323-469-5555
Mailing Address
Mr. JON CHARLES LACY PA
6368 HOLLYWOOD BLVD
LOS ANGELES, CA 90028-6320
Phone number: 323-469-5555
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