Lacey L Jandrin, PA-C

NPI #1104183516 in Green Bay, Wisconsin

Provider Information

NPI Number: 1104183516
Entity Type: Individual
Name: Lacey L Jandrin, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: PA-C
Enumeration Date: Apr 23, 2012
Last Updated: Jan 30, 2023

Practice Location

Address: 1970 S RIDGE RD
City: Green Bay
State: Wisconsin
ZIP Code: 54304-4125
Phone: (920) 430-4888

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary
Physician Assistant	363A00000X

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