Search › Virginia › 363A00000X
Jeffrey Lackore, PA
NPI 1306879192 · on the registry since 2006
Practice
- Address
- 6120 Sandhurst Dr
Roanoke, VA 24018 - Phone
- (712) 253-6104
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363A00000X
- Licence states on file
- VA, CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2009-08-24
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia