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General NPI Number Information
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NPI Number | 1891092615
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Entity Type | Individual
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Provider Name | LANDON LEE LALONDE AT
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Gender | Male
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Dates
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Enumeration Date | 02/14/2011
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Last Update Date | 02/14/2011
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Provider Practice Location Address
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Address Line | 2400 WEISS ST
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City | SAGINAW
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State | MI
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Zip | 48602-3858
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Country | US
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Telephone | 989-205-8839
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Fax |
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Provider Business Mailing Address
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Address Line | 4309 LINGLESTOWN RD
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City | HARRISBURG
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State | PA
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Zip | 17112-8624
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Country | US
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Telephone | 866-651-9510
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Fax | 717-651-9512
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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 | 2601000460
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License Number State | MI
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