Provider Demographics
NPI:1720397888
Name:AKRIDGE, LACEY MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:LACEY
Middle Name:MICHELLE
Last Name:AKRIDGE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3811 TWIN CREEK DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-4000
Mailing Address - Country:US
Mailing Address - Phone:402-884-4774
Mailing Address - Fax:
Practice Address - Street 1:3811 TWIN CREEK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-4000
Practice Address - Country:US
Practice Address - Phone:402-884-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1628111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor