Individual
MRS. CHANTELLE LASSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6285 S HIGLEY RD, GILBERT, AZ 85298
(480) 460-4949
(480) 490-5858
Mailing address
6285 S HIGLEY RD, GILBERT, AZ 85298-4262
(480) 460-4949
(480) 460-5858
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3064
AZ
363AM0700X
Medical Physician Assistant
Primary
3064
AZ
Other
Enumeration date
09/28/2006
Last updated
10/14/2021
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