Individual
RICHELLE LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5000
Mailing address
10911 AUGUST CT, CHESTERFIELD, VA 23832-7041
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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