Individual
LAMAR RICHARD INNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4190 W HIGHWAY 80, DOUGLAS, AZ 85607-6100
(520) 417-4124
(520) 417-4096
Mailing address
4190 W HIGHWAY 80, DOUGLAS, AZ 85607-6100
(520) 417-4124
(520) 417-4096
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1203
AZ
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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