Chancelor Lucas Hernandez, MA, ATC, LAT
NPI #1336529296 in Beaver Dam, Wisconsin
Provider Information
- NPI Number
- 1336529296
- Entity Type
- Individual
- Name
- Chancelor Lucas Hernandez, MA, ATC, LAT
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- MA, ATC, LAT
- Enumeration Date
- Jun 5, 2015
- Last Updated
- Jun 5, 2015
Practice Location
- Address
- 707 S UNIVERSITY AVE
- City
- Beaver Dam
- State
- Wisconsin
- ZIP Code
- 53916-3027
- Phone
- (920) 219-4009
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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