MS. Lacey Wise, PT

NPI #1154830677 in Castle Rock, Washington

Provider Information

NPI Number: 1154830677
Entity Type: Individual
Name: MS. Lacey Wise, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Sep 27, 2017
Last Updated: Mar 26, 2024

Practice Location

Address: 1316 MT SAINT HELENS WAY SE
Address 2: SUITE B
City: Castle Rock
State: Washington
ZIP Code: 98611
Phone: (360) 557-8020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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