Individual
LACEY ANITA BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
148 SAULS ST STE B, LAKE CITY, SC 29560-2677
(843) 374-0185
(843) 374-0189
Mailing address
148 SAULS ST STE B, LAKE CITY, SC 29560-2677
(843) 374-0185
(843) 374-0189
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9459
SC
Other
Enumeration date
02/24/2021
Last updated
02/24/2021
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