Individual
LACY MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
544 YELLOWSTONE AVE, CODY, WY 82414-9300
(307) 587-9789
(307) 587-9787
Mailing address
544 YELLOWSTONE AVE, CODY, WY 82414-9300
(307) 587-9789
(307) 587-9787
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1885
WY
Other
Enumeration date
08/09/2016
Last updated
12/05/2022
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