# LACEY MCROY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1811322845
- **Gender:** F
- **Credential:** PT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 070020112 | IL | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | 070020112 | IL | — |
| 225100000X | Physical Therapist | 13273 | WI | Yes |

## Other

- **Enumeration date:** 09/10/2013
- **Last updated:** 01/12/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 070020112 | — | IL |