Individual
LACY LAKAY CANZONERI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16143 THOMAS AVE, ALLEN PARK, MI 48101-1951
(313) 999-8142
Mailing address
16143 THOMAS AVE, ALLEN PARK, MI 48101-1951
(313) 999-8142
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
—
—
247200000X
Other Technician
Primary
C525488488098
MI
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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