Individual
LACEY MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC LAT
Contact information
Practice address
1600 E EUCLID ST, MCPHERSON, KS 67460-3847
(620) 474-0427
Mailing address
1600 E EUCLID ST, MCPHERSON, KS 67460-3847
(620) 474-0427
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00846
KS
Other
Enumeration date
03/06/2017
Last updated
03/06/2017
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