MR. Shane A Lacaillade, IDMT
NPI #1881829497 in Whiteman Afb, Missouri
Provider Information
- NPI Number
- 1881829497
- Entity Type
- Individual
- Name
- MR. Shane A Lacaillade, IDMT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Military Health Care Provider - Independent Duty Medical Technicians
- Credential
- IDMT
- Enumeration Date
- May 27, 2009
- Last Updated
- May 27, 2009
Practice Location
- Address
- 331 SIJAN AVE
- City
- Whiteman Afb
- State
- Missouri
- ZIP Code
- 65305-1269
- Phone
- (660) 687-1191
Specialties & Taxonomy Codes
| Specialty |
|---|
| Military Health Care Provider - Independent Duty Medical Technicians — Independent Duty Medical Technicians |
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