Individual
TYLER LACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 W VERNON AVE, FERGUS FALLS, MN 56537-2741
(218) 739-2221
Mailing address
712 S CASCADE ST, FERGUS FALLS, MN 56537-2913
(218) 736-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
64592
MN
Other
Enumeration date
04/21/2017
Last updated
07/02/2024
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