Individual
MR. COREY JUSTIN LACZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
62 ALUMNI DR, CASTLETON, VT 05735-4454
(802) 779-6666
Mailing address
138 HIGHLAND AVE, WEST RUTLAND, VT 05777-9412
(802) 779-2666
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/17/2022
Last updated
10/31/2023
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