Individual
LACY LEE KNUTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
823 S 17TH ST, FORT DODGE, IA 50501-5345
(515) 570-9822
Mailing address
823 S 17TH ST, FORT DODGE, IA 50501-5345
(515) 570-9822
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PP5255
IA
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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