Individual
LACIE KENDALL GEISEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
315 E WILSON ST, WINGATE, NC 28174-9665
(410) 924-0685
Mailing address
315 E WILSON ST, WINGATE, NC 28174-9665
(410) 924-0685
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/25/2016
Last updated
06/19/2023
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