Individual
DESMOND DE'VON LACY-BARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1102 WALTON AVE, RACINE, WI 53402-4549
(262) 598-7590
Mailing address
1102 WALTON AVE, RACINE, WI 53402-4549
(262) 598-7590
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
WI
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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