Individual
MICHAEL J. LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
3240 SUNSET BLVD, WEST COLUMBIA, SC 29169-3428
(803) 796-8377
(803) 796-8378
Mailing address
825 GOLDEN EYE CT, BLYTHEWOOD, SC 29016-9250
(803) 767-9431
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
40QA01093000
NJ
225100000X
Physical Therapist
Primary
5400
SC
Other
Enumeration date
03/02/2006
Last updated
02/12/2008
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