Individual
MISS PAYTON LACZYNSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
24518 LAKEWOODS LN, SHOREWOOD, IL 60404-0676
(815) 482-5562
Mailing address
24518 LAKEWOODS LN, SHOREWOOD, IL 60404-0676
(815) 482-5562
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004448
IL
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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