Individual
ZANDER GABRIEL LICHOSIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25 BEAMER WAY, BLACKSBURG, VA 24061-6267
(414) 731-5342
Mailing address
320 CONTINENTAL CIR APT 201, CHRISTIANSBURG, VA 24073-1209
(414) 731-5342
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126004290
VA
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/19/2024
Last updated
06/16/2025
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