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Lacy Mroz

NPI Registration Record

Provider / OrganizationNPIDate Certified
LACY MROZ11448354142020-09-13
Entity TypeIndividual
Provider Name Lacy Mroz DPT
Practice Office Address101 W MAIN ST
SYRACUSE, IN US
Practice Office Telephone9419618280
Mailing Address101 W MAIN ST
SYRACUSE, IN 465671126 US
Business Telephone9419618280
HPT Codes
CodeLicense NoState
225100000X PRIMARY05013924A IN
OPI Codes

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