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Individual

LACIE WINDSOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1492 TINY TOWN RD STE A1A2, CLARKSVILLE, TN 37042-7873
(615) 758-1030
Mailing address
1537 EDGEWATER LN, CLARKSVILLE, TN 37043-3667

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
16126
TN
225100000X
Physical Therapist
Primary
PT43294
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
JZKXZ9581251
BLUECROSS BLUESHIELD
MN
Enumeration date
12/23/2016
Last updated
07/11/2025
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