Individual
LAUREN MARIE FACKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 MYERS CORNER DR, STAUNTON, VA 24401-6342
(540) 688-2646
Mailing address
1060 SHENANDOAH ST APT A, HARRISONBURG, VA 22802-5447
(540) 391-1091
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-006810
VA
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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