Individual
LACEY WILCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1833 E BISMARCK EXPY, BISMARCK, ND 58504-6708
(701) 323-5222
(701) 323-5867
Mailing address
1833 E BISMARCK EXPRESSWAY, BISMARCK, ND 58504
(701) 839-5902
(701) 839-5909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1640
ND
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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