Individual
DARRYL O LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
903 S 12TH ST, ROCKY FORD, CO 81067-2127
(719) 254-7623
(719) 254-5112
Mailing address
128 MARKET ST, ALAMOSA, CO 81101-2290
(719) 589-5161
(719) 589-5722
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2537
CO
Other
Enumeration date
11/27/2007
Last updated
11/27/2007
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