Individual
RYAN D LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MAT, ATC
Contact information
Practice address
4909 39TH ST, LUBBOCK, TX 79414-2708
(180) 678-6464
Mailing address
4909 39TH ST, LUBBOCK, TX 79414-2708
(180) 678-6464
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000041029
TX
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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