Individual
ELAINE M LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
667 S RIVER ST, PLAINS, PA 18705
(570) 824-4111
(570) 824-3167
Mailing address
667 S RIVER ST, PLAINS, PA 18705-1013
(570) 824-4111
(570) 824-3167
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA001683L
PA
Other
Enumeration date
10/23/2006
Last updated
11/28/2018
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