Individual
JACOB MICHAEL LEZON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30501 NEVINS ST., FT. RUCKER, AL 36362
(334) 255-8071
Mailing address
30501 NEVINS ST., FT. RUCKER, AL 36362
(334) 255-8071
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E3497387
TX
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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