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Individual

DR. JASON NICHOLAS LAZOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
2770 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-8614
(616) 267-8860
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS015665
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
5101020228
MI

Other

Enumeration date
06/18/2009
Last updated
11/05/2024
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