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1003514456
SUMMER ELIZABETH LACKEY
STATESVILLE, NC
NPI
1003514456
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 0010-12966)
Enumeration Date
2023-02-15
Last Update Date
2023-03-27
Business Address
SUMMER ELIZABETH LACKEY PA
705 GAITHER RD
STATESVILLE, NC 28625-3450
Phone number: 704-871-1155
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Mailing Address
SUMMER ELIZABETH LACKEY PA
PO BOX 1845
STATESVILLE, NC 28687-1845
Phone number: 704-873-4277
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