LACEY M RUNYON

WAUKESHA, WI
NPI1811951700
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IN  36001401A)
Enumeration Date2006-04-17
Last Update Date2023-05-09
Business Address
Miss LACEY M RUNYON DAT, LAT, ATC
100 N EAST AVE
WAUKESHA, WI 53186-3103
Phone number: 262-524-7202
Mailing Address
Miss LACEY M RUNYON DAT, LAT, ATC
7100 ASHWOOD LN
WATERFORD, WI 53185-2170
Phone number: 219-863-9119
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