Individual
MS. LACEY SLAUGHTER SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2405 OSLER CT, SUITE 200, ALBANY, GA 31707-0214
(229) 883-4009
(229) 883-4320
Mailing address
229 WILLOW LAKE DR, LEESBURG, GA 31763-5379
(229) 888-1336
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA001576
GA
Other
Enumeration date
03/21/2013
Last updated
08/27/2013
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