Individual
KENEDI ALEXUS LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
7985 KNIGHT RD, GAINESVILLE, GA 30506-6427
(770) 781-4899
Mailing address
7985 KNIGHT RD, GAINESVILLE, GA 30506-6427
(770) 781-4899
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT017294
GA
Other
Enumeration date
08/21/2024
Last updated
10/11/2024
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