| NPI | 1104183516 |
|---|---|
| Former Name | LACEY L BARTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 3761-23) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: WI 4712) |
| 363A00000X Physician Assistant (Licence: WI 1135070) | |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2023-01-30 |