Individual
MR. ANDREW THOMAS LACEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3660 S COX AVE APT 1206, SPRINGFIELD, MO 65807-6927
(312) 241-5257
Mailing address
3660 S COX AVE APT 1206, SPRINGFIELD, MO 65807-6927
(312) 241-5257
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2022009916
MO
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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