Individual
ALICIA ANNE LAVIGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
2868 DAMASCUS RD, HEBRON, KY 41048-9745
(859) 640-1434
Mailing address
2868 DAMASCUS RD, HEBRON, KY 41048-9745
(859) 640-1434
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000056702
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
07/10/2023
Last updated
10/15/2024
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