Individual
LACEY POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
775 CHICKASAW DR, MADISONVILLE, KY 42431-3903
(270) 584-4482
Mailing address
775 CHICKASAW DR, MADISONVILLE, KY 42431-3903
(270) 584-4482
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A03771
KY
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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