Individual
MRS. LACEY LEANN WESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
889 EAST MAIN ST., MELBOURNE, AR 72556
(870) 368-4586
(870) 368-4587
Mailing address
P.O. BOX 134, SAGE, AR 72573
(870) 291-0361
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2053
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122852742
—
AR
05
—
145863778
—
AR
05
—
160417721
—
AR
Enumeration date
02/27/2007
Last updated
08/09/2022
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