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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

CHANCELOR LUCAS HERNANDEZ, MA, ATC, LAT

Active Sole Proprietor

CHANCELOR LUCAS HERNANDEZ, MA, ATC, LAT is a Athletic Trainer healthcare provider located in BEAVER DAM, Wisconsin. NPI 1336529296 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · BEAVER DAM, WI

Registration Details

NPI Number
1336529296
Provider Type
Individual
Gender
Male
NPI Issued
Jun 5, 2015 (11.166877654978 yrs)
Last Updated
Jun 5, 2015
License
1063-39 (WI)
Sole Proprietor
Yes

Practice Information

Address
707 S UNIVERSITY AVE
BEAVER DAM, WI, 539163027
Browse WI providers · Browse ZIP 53916
Phone
9202194009
Primary Specialty
Athletic Trainer
2255A2300X

Other Athletic Trainer Providers in BEAVER DAM, WI

Name Credential NPI
MR. MATTHEW TOMAS LUNDIN ATC 1194754267
ELIZABETH A HANSMANN LAT 1851404248
MICHELLE WOODS LAT 1992140925
JANICE KATHRYN HAMACHEK KELLNER 1609269752
GREGORY BEIER 1689125064
LORENA GALVAN 1043043292
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.