Individual
LACEY KELL TIERNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
827 PERSHING ST, SEYMOUR, IN 47274-1219
(317) 874-6810
Mailing address
827 PERSHING ST, SEYMOUR, IN 47274-1219
(317) 874-6810
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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