Individual
LANCE AARON WENZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2100 E CALUMET ST, CENTRALIA, IL 62801-6511
(618) 532-7391
(618) 532-8952
Mailing address
2884 E FOX RD, CENTRALIA, IL 62801-8807
(618) 780-0430
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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