Individual
ALICIA MARIE LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
19 BACHELDER RD, OLD TOWN, ME 04468-1217
(203) 843-2930
Mailing address
19 BACHELDER RD, OLD TOWN, ME 04468-1217
(203) 843-2930
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT856
ME
Other
Enumeration date
06/10/2015
Last updated
08/24/2023
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