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Individual

MISS LACEY C GREGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(216) 347-9885
Mailing address
1082 FRESNO DR, WESTLAKE, OH 44145-2728
(254) 290-8535

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.005995RX
OH

Other

Enumeration date
12/13/2013
Last updated
12/08/2024
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