Individual
MRS. CRYSTAL LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
509 W WASHINGTON ST, ALLIANCE, OH 44601-1611
(330) 564-3042
Mailing address
509 W WASHINGTON ST, ALLIANCE, OH 44601-1611
(330) 564-3042
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN.171598.MEDS-IV
OH
Other
Enumeration date
12/31/2020
Last updated
12/31/2020
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