Lacey Marie Strack PA-C

NPI 1114252087 - Physician Assistant - 363A00000X

NPI Details
NPI 1114252087
Gender Female
Enumeration Date 10/12/2009
Last Updated 10/12/2009
Entity Type Individual
Active Over 7 years ago
Practice Location
600 E 1ST ST
SPRING VALLEY IL, 61362-1512, US
Phone (515) 663-8009
Fax
Business Location
600 E 1ST ST
SPRING VALLEY IL, 61362-1512, US
Phone (515) 663-8009
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Illinois
License Number 085.003635
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According to our database, Miss Lacey Marie Strack PA-C NPI is 1114252087, taxonomy code is 363A00000X and license number is 085.003635, license state is located at Illinois. Lacey Marie Strack PA-C physically located at 600 E 1st St, Spring Valley IL, 61362-1512. NPI Number Lacey Marie Strack PA-C has the Individual type.

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1114252087 NPI number is provided on an as is basis without warranty of any kind. 1114252087 is maintained by the National Plan & Provider Enumeration System. The contents of Lacey Marie Strack PA-C are for informational purposes only.