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Individual

CHASE WESLEY LAZENBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
405 W GRAND AVE, DAYTON, OH 45405-7538
(937) 723-3245
Mailing address
405 W GRAND AVE, DAYTON, OH 45405-7538
(937) 723-3245

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
34.014118
OH
207P00000X
Emergency Medicine Physician
Primary
9445
AZ

Other

Enumeration date
04/19/2018
Last updated
04/25/2022
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