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1689946071
JASON LANTZ WHITE
MOODY A F B, GA
NPI
1689946071
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1003X Military Health Care Provider, Independent Duty Medical Technicians
Enumeration Date
2012-02-01
Last Update Date
2012-02-01
Business Address
-- JASON LANTZ WHITE IDMT
3280 MITCHELL BLVD
MOODY A F B, GA 31699-1500
Phone number: 229-257-2105
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Mailing Address
-- JASON LANTZ WHITE IDMT
3807 ROBIN LN
VALDOSTA, GA 31605-5124
Phone number: 229-560-1598
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