SHANE A LACAILLADE

WHITEMAN AFB, MO
NPI1881829497
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1003X Military Health Care Provider, Independent Duty Medical Technicians
Enumeration Date2009-05-27
Last Update Date2009-05-27
Business Address
Mr. SHANE A LACAILLADE IDMT
331 SIJAN AVE
WHITEMAN AFB, MO 65305-1269
Phone number: 660-687-1191
Mailing Address
Mr. SHANE A LACAILLADE IDMT
1307 SHAMROCK CT
WARRENSBURG, MO 64093-2490
Phone number: 660-747-3477
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