NPI 1356809776

Gabriel M Lacewell

Practitioner Driver Fayetteville, NC

Practice location

Address: 223 Randolph Ave, Fayetteville, NC 28311-2742
Phone: (910) 527-2481

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 26079338 (NC)

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Registry record

NPI: 1356809776
Entity type: Individual
Sex (as registered): Male
NPI issued: 5 Mar 2019
Record last updated: 5 Mar 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.