Individual
JOHN P LACEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3200 PLEASANT VALLEY RD, WEST BEND CLINIC-UROLOGY, WEST BEND, WI 53095-9274
(262) 836-7300
(262) 836-7300
Mailing address
3200 PLEASANT VALLEY RD, WEST BEND CLINIC-UROLOGY, WEST BEND, WI 53095-9274
(262) 836-7300
(262) 836-7300
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
31345
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578645305
—
WI
01
—
7708
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/20/2006
Last updated
09/05/2013
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