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Individual

LACY NICOLE SANTANA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
340 BRAKEFIELD ST, SLIDELL, LA 70458-3620
(985) 265-7364
Mailing address
74345 ETA AVE, COVINGTON, LA 70435-5410
(985) 502-9303

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11111
LA

Other

Enumeration date
11/09/2022
Last updated
11/09/2022
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