Individual
LORIE LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1310 SW CORONA CT SUITE B, WALDPORT, OR 97394
(971) 218-2432
Mailing address
1310 SW CORONA CT SUITE B, WALDPORT, OR 97394
(971) 218-2432
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13352
OR
Other
Enumeration date
01/07/2010
Last updated
05/11/2023
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