Individual
DARRICK TAYLOR LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 S 5TH W, IDAHO FALLS, ID 83402-7309
(208) 220-8327
Mailing address
218 CEMETERY RD UNIT 10, POCATELLO, ID 83202-7061
(208) 220-8327
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
07/29/2025
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