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1770180903
KENNETH LASSITER
FAYETTEVILLE, NC
NPI
1770180903
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: NC 20000190028)
Enumeration Date
2020-10-01
Last Update Date
2021-12-23
Business Address
KENNETH LASSITER MS, ATC, LAT
1200 MURCHISON RD
FAYETTEVILLE, NC 28301-4252
Phone number: 336-953-0668
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Mailing Address
KENNETH LASSITER MS, ATC, LAT
6528 TAMPICO CT
FAYETTEVILLE, NC 28303-2334
Phone number: 336-953-0668
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