Individual
LANCE MANDERNACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS, RTT
Contact information
Practice address
3371 GLENDALE BLVD, #186, LOS ANGELES, CA 90039-1825
(323) 666-5364
Mailing address
3371 GLENDALE BLVD, #186, LOS ANGELES, CA 90039-1825
(323) 666-5364
Taxonomy
Speciality
Code
Description
License number
State
2865M2000X
Military General Acute Care Hospital
Primary
—
—
Other
Enumeration date
02/22/2008
Last updated
02/22/2008
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