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General NPI Number Information
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NPI Number | 1437128923
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Entity Type | Individual
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Provider Name | SUZANNE CHRISTINE LACHANCE ATC, CSCS
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Gender | Female
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2121 OAK VALLEY DR
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City | ANN ARBOR
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State | MI
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Zip | 48103-8901
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Country | US
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Telephone | 734-998-8600
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Fax | 734-998-8599
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Provider Business Mailing Address
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Address Line | 1937 SPRUCE LN
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City | SUPERIOR TOWNSHIP
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State | MI
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Zip | 48198-9508
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Country | US
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Telephone | 734-482-1875
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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