Most Relevant Information
Provider Data
| NPI Number: | 1003347451 |
| Provider Name: | ANTHONY LAZARO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/27/2017 |
| Last Updated: | 11/19/2021 |
Provider Practice Location
2600 KILEY WAY
PLYMOUTH
WI
530735020
Practice Location Phone/Fax
| Phone: | 9204497000 |
| Fax: |
Provider Mailing Location
3301 W FOREST HOME AVE
MILWAUKEE
WI
532152843
Provider Mailing Phone/Fax
| Phone: | 4143892233 |
| Fax: |