Individual
MICHAEL JOHN LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1403 MONTEREY PL, SANTA FE, NM 87505-3864
(505) 820-5685
Mailing address
1403 MONTEREY PL, SANTA FE, NM 87505-3864
(505) 820-5685
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4574
NM
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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