Individual
JUSTIN J LACROSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
610 S LINCOLN RD, ESCANABA, MI 49829-1215
(906) 786-6488
(906) 786-6409
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101020781
MI
Other
Enumeration date
07/03/2013
Last updated
09/27/2023
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