Provider Demographics
NPI:1548799307
Name:HALE-CONARD, LACIE RICHELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:LACIE
Middle Name:RICHELLE
Last Name:HALE-CONARD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 S. MAIN ST.
Mailing Address - Street 2:SUITE A
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804
Mailing Address - Country:US
Mailing Address - Phone:417-726-9137
Mailing Address - Fax:
Practice Address - Street 1:2722 S MAIN ST
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-2635
Practice Address - Country:US
Practice Address - Phone:620-674-1940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017017164152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist