Individual
MARY KATHLEEN LACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
559 WILLIVEE DR, DECATUR, GA 30033-5406
(404) 325-4897
Mailing address
559 WILLIVEE DR, DECATUR, GA 30033-5406
(404) 325-4897
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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