Ian David Lackey, ATC
NPI #1609325539 in Vermillion, South Dakota
Provider Information
- NPI Number
- 1609325539
- Entity Type
- Individual
- Name
- Ian David Lackey, ATC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC
- Enumeration Date
- Oct 4, 2016
- Last Updated
- Oct 4, 2016
Practice Location
- Address
- 414 E CLARK ST
- City
- Vermillion
- State
- South Dakota
- ZIP Code
- 57069-2307
- Phone
- (605) 658-5541
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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