Individual
LACY KRYSL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 PARK AVE, GREGORY, SD 57533-1302
(605) 835-5190
Mailing address
400 PARK AVE, GREGORY, SD 57533-1302
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1170
SD
225X00000X
Occupational Therapist
1735
NE
Other
Enumeration date
06/10/2016
Last updated
08/25/2020
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