Most Relevant Information
Provider Data
| NPI Number: | 1003037821 |
| Provider Name: | LANCE AVON MICHEL ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 0063 |
Most Important Dates
| Enumeration Date: | 05/01/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
2506 S SORRELLE
MESA
AZ
85209
Practice Location Phone/Fax
| Phone: | 4809855722 |
| Fax: |
Provider Mailing Location
2506 S SORRELLE
MESA
AZ
85209
Provider Mailing Phone/Fax
| Phone: | 4809855722 |
| Fax: |