Individual
MR. LAMOYNE HAWLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT,C
Contact information
Practice address
10320 75TH ST, KENOSHA, WI 53142-7525
(262) 697-6143
Mailing address
9984 50TH AVE, PLEASANT PRAIRIE, WI 53158-6530
(262) 308-6968
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
12-039
WI
Other
Enumeration date
01/29/2007
Last updated
06/01/2023
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