Individual
KORY JAYDEN LAZUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
70 LOVELAND HILL RD, VERNON, CT 06066-6836
(860) 870-6314
Mailing address
21 JOHNSTON AVE, WILLIMANTIC, CT 06226-3207
(860) 917-7950
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000056296
CT
Other
Enumeration date
07/04/2024
Last updated
07/04/2024
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