Provider Demographics
NPI:1912406299
Name:SMIESKO, LACY (DC)
Entity Type:Individual
Prefix:DR
First Name:LACY
Middle Name:
Last Name:SMIESKO
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 1:609 ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-2003
Mailing Address - Country:US
Mailing Address - Phone:412-828-0700
Mailing Address - Fax:
Practice Address - Street 1:609 ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:OAKMONT
Practice Address - State:PA
Practice Address - Zip Code:15139-2003
Practice Address - Country:US
Practice Address - Phone:412-828-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011341111N00000X
PAF03909237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No111N00000XChiropractic ProvidersChiropractor