Individual
GARY ROBERT LANCASTER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PSY
Contact information
Practice address
18396 TUOLUMNE ROAD, SUITE 9, TUOLUMNE, CA 95379
(209) 928-4816
(209) 928-3636
Mailing address
PO BOX 2080, MACT HEALTH BOARD INC, TUOLUMNE, CA 95379-2080
(209) 928-4278
(209) 928-3636
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY4671
CA
Other
Enumeration date
05/24/2006
Last updated
07/08/2007
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