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General NPI Number Information
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NPI Number | 1952849853
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Entity Type | Individual
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Provider Name | TRACY LYNN LENOIR LAT,ATC
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Gender | Female
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Dates
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Enumeration Date | 02/10/2017
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 1010 ECHO TRL
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City | EASTON
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State | PA
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Zip | 18040-1020
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Country | US
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Telephone | 610-250-2460
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Fax | 610-250-2613
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Provider Business Mailing Address
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Address Line | 718 PARDEE ST
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City | EASTON
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State | PA
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Zip | 18042-1420
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Country | US
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Telephone | 610-250-2460
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | RT004187
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License Number State | PA
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