Individual
LACY RUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
915 E MARKET AVE, SEARCY, AR 72149-5615
(501) 279-5457
Mailing address
PO BOX 12281, SEARCY, AR 72149-0001
(501) 279-5457
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
550
AR
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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