Individual
LACEY M REED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3367 S MERCY RD STE 210, GILBERT, AZ 85297-7604
(480) 969-4138
(480) 969-0630
Mailing address
2320 N 3RD ST, PHOENIX, AZ 85004-1303
(602) 258-9900
(602) 258-9904
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
6783
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D07025791
DRIVERS LICENSE
AZ
Enumeration date
08/01/2017
Last updated
09/01/2022
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