Individual
GABRIEL LANTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 N WALNUT ST, BLOOMINGTON, IN 47404-2069
(812) 340-9129
Mailing address
615 N STAATS DR, BLOOMINGTON, IN 47408-2737
(812) 340-9129
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
05/09/2019
Last updated
05/09/2019
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