Shanon Renee Lacy D.O.

NPI 1003076142 - Pathology - 207ZD0900X

NPI Details
NPI 1003076142
Gender Female
Enumeration Date 06/12/2008
Last Updated 07/16/2012
Entity Type Individual
Active Over 8 years ago
Practice Location
8901 W LINCOLN AVE
WEST ALLIS WI, 53227-2409, US
Phone (414) 328-7675
Fax
Business Location
102 N WATER ST UNIT 206
MILWAUKEE WI, 53202-6056, US
Phone (317) 285-9918
Fax
Toxanomy
Taxonomy Code 207ZD0900X
License State Wisconsin
License Number 56999-21
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According to our database, Dr. Shanon Renee Lacy D.O. NPI is 1003076142, taxonomy code is 207ZD0900X and license number is 56999-21, license state is located at Wisconsin. Shanon Renee Lacy D.O. physically located at 8901 W Lincoln Ave, West Allis WI, 53227-2409. NPI Number Shanon Renee Lacy D.O. has the Individual type.

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1003076142 NPI number is provided on an as is basis without warranty of any kind. 1003076142 is maintained by the National Plan & Provider Enumeration System. The contents of Shanon Renee Lacy D.O. are for informational purposes only.