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1881017655
LACEY TUDOR
MECHANICSVILLE, VA
NPI
1881017655
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Former Name
LACEY LUMPKIN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: VA 0110004486)
Enumeration Date
2014-01-29
Last Update Date
2014-01-29
Business Address
-- LACEY TUDOR PA
8260 ATLEE RD EMERGENCY DEPT.
MECHANICSVILLE, VA 23116-1844
Phone number: 804-764-6300
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Mailing Address
-- LACEY TUDOR PA
38935 ANN ARBOR RD CREDENTIALING DEPT
LIVONIA, MI 48150-3397
Phone number: 734-805-0488
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