Individual
ANGEL LOUIS LAZU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
276 RECREATION BLDG # 147D, STATE COLLEGE, PA 16802-5701
(814) 867-0478
Mailing address
501 VAIRO BLVD APT 1112, STATE COLLEGE, PA 16803
(267) 394-0822
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT007381
PA
Other
Enumeration date
09/06/2020
Last updated
09/06/2020
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