Individual
MR. CHARLES CARL LACY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7000 FRANKLIN BLVD STE 200, SACRAMENTO, CA 95823-1865
(916) 394-9195
Mailing address
7000 FRANKLIN BLV. #200, SACRAMENTO, CA 95823
(916) 394-9195
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/28/2007
Last updated
08/14/2015
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