Individual
EDWARD LUCAS ZELAZNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2069 WILLISTON RD, SOUTH BURLINGTON, VT 05403-6072
(802) 658-5800
Mailing address
60 AUSTIN DR, APT 2, BURLINGTON, VT 05401
(802) 825-5663
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
104.0113349
VT
Other
Enumeration date
07/14/2015
Last updated
07/27/2015
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