Individual
ALEXIS MARCIA LACEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
131 MILLER ST, WINSTON SALEM, NC 27103-2508
(336) 716-8847
Mailing address
125 WESTDALE AVE, WINSTON SALEM, NC 27101-3619
(910) 874-5181
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P22061
NC
Other
Enumeration date
06/23/2023
Last updated
06/23/2023
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