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Individual

CHRISTOPHER J. LACY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.A.

Contact information

Practice address
146 SW ORTHOPEDIC CT, LAKE CITY, FL 32024-0672
(386) 719-5100
(386) 719-5101
Mailing address
4500 W NEWBERRY RD, GAINESVILLE, FL 32607-2245
(352) 336-6000
(352) 332-0799

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 21841
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTA 21841
PTA LICENSE
FL
Enumeration date
09/11/2009
Last updated
02/19/2015
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