| NPI | 1508173733 |
|---|---|
| Former Name | LACEY ERWIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23554) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC P12832) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2018-04-11 |