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Individual

MICHAEL T LA NOU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
580 LINCOLN PARK BLVD, SUITE 322, KETTERING, OH 45429-3474
(937) 297-6800
(937) 297-6810
Mailing address
5334 LEATHERWOOD DR, WEST CHESTER, OH 45069-1876
(715) 441-1368

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1900
WI
363AS0400X
Surgical Physician Assistant
50002733
OH

Other

Enumeration date
08/31/2006
Last updated
02/11/2008
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