Individual
GUILIO LACROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5734 COVENTRY LN, FORT WAYNE, IN 46804-7141
(260) 436-7875
Mailing address
PO BOX 633260, CINCINNATI, OH 45263-3260
(317) 802-6303
(317) 870-0499
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01034126
IN
Other
Enumeration date
10/25/2005
Last updated
10/29/2007
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