Individual
MRS. LACEY M. O'HARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 BARTOL AVE, SUITE 10, RIDLEY PARK, PA 19078-2214
(610) 521-0150
(610) 521-6493
Mailing address
207 N BROAD ST, 3RD FLOOR, PHILADELPHIA, PA 19107-1500
(267) 479-4165
(215) 463-3820
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA-055141
PA
Other
Enumeration date
02/02/2012
Last updated
02/06/2017
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