Provider Demographics
NPI:1629234356
Name:LAZAR, JONATHAN EUGENE (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:EUGENE
Last Name:LAZAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 S ZEEB RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-8326
Mailing Address - Country:US
Mailing Address - Phone:734-274-5107
Mailing Address - Fax:877-890-6994
Practice Address - Street 1:203 S ZEEB RD
Practice Address - Street 2:SUITE 106
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-8326
Practice Address - Country:US
Practice Address - Phone:734-274-5107
Practice Address - Fax:877-890-6994
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009433111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor