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1235596420
LACEY REBECCA DUNGAN
FAIRFAX, VA
NPI
1235596420
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: VA 0126002412)
Enumeration Date
2016-01-20
Last Update Date
2016-01-20
Business Address
-- LACEY REBECCA DUNGAN ATC
10523 MAIN ST
FAIRFAX, VA 22030-3310
Phone number: 703-380-8141
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Mailing Address
-- LACEY REBECCA DUNGAN ATC
4220 RALEIGH AVE APT 202
ALEXANDRIA, VA 22304-5338
Phone number: 610-348-8995
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