Individual
DR. KYLE WILLIAM LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 ST. ANTOINE, UHC 6D5.5, DETROIT, MI 48201
(313) 966-8013
Mailing address
724 YORK ST, PLYMOUTH, MI 48170-1483
(949) 257-6183
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301097292
MI
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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