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NPI Code Detail

MEDICARE: ANTHONY LE LOMACK

MEDICARE:   ANTHONY LE LOMACK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172A00000XDriverRS934860OH

General Provider Information

NPI Number : 1639953987
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY LE LOMACK
Provider Business Mailing Address
First Line : 820 JONATHAN AVE
Second Line :
City : AKRON
State : OH
Zip : 44306-3607
Country : US
Telephone Number : 330-907-8607
Fax Number :
Provider Business Practice Location Address
First Line : 820 JONATHAN AVE
Second Line :
City : AKRON
State : OH
Zip : 44306-3607
Country : US
Telephone Number : 330-907-8607
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2023
Last Update Date : 08/18/2023

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Directions to “ ANTHONY LE LOMACK ” Practice Location

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