Tracey Lasane

NPI #1134824998 in Lake Park, Georgia

Provider Information

NPI Number: 1134824998
Entity Type: Individual
Name: Tracey Lasane
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Driver
Enumeration Date: Apr 3, 2023
Last Updated: Apr 3, 2023

Practice Location

Address: 5114 DIAMOND DR
City: Lake Park
State: Georgia
ZIP Code: 31636-3087
Phone: (850) 739-1233

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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