Individual
LACEY VOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
130 CAMBRIA WAY, SANTA ROSA, CA 95403-7847
(707) 568-7176
Mailing address
130 CAMBRIA WAY, SANTA ROSA, CA 95403-7847
(707) 568-7176
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
13480755
CA
Other
Enumeration date
09/06/2013
Last updated
09/06/2013
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