Organization
CLEVELAND STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS LACSAMANA (HEAD ATHLETICS TRAINER)
(216) 687-5287
Entity
Organization
Contact information
Practice address
2121 EUCLID AVE, CLEVELAND, OH 44115-2214
(216) 687-5287
Mailing address
PO BOX 819020, DALLAS, TX 75381-9020
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/19/2011
Last updated
09/19/2011
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