Individual
GERALD GUY LACHANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1360 BRICKYARD RD, CHIPLEY, FL 32428-6303
(850) 415-8303
(207) 795-8490
Mailing address
1360 BRICKYARD RD, CHIPLEY, FL 32428-6303
(850) 415-8303
(207) 795-8490
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1707
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113382300
—
FL
Enumeration date
04/05/2006
Last updated
08/09/2024
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