Individual
MR. LANCE MALO FUJIWARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED, ATC
Contact information
Practice address
307 LETCHER AVE, LEXINGTON, VA 24450-2109
(540) 570-0270
(540) 464-7280
Mailing address
307 LETCHER AVE, LEXINGTON, VA 24450-2109
(540) 570-0270
(540) 464-7280
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000244
VA
Other
Enumeration date
05/11/2012
Last updated
05/11/2012
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