Provider Demographics
NPI:1740215813
Name:LACEY, MICHAEL THOMAS (RKT, CSCS)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:THOMAS
Last Name:LACEY
Suffix:
Gender:M
Credentials:RKT, CSCS
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Mailing Address - Street 1:106 LINKS DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16101-6286
Mailing Address - Country:US
Mailing Address - Phone:724-674-6109
Mailing Address - Fax:330-534-9632
Practice Address - Street 1:609 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-1750
Practice Address - Country:US
Practice Address - Phone:330-534-8500
Practice Address - Fax:330-534-3926
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist