Lacie Wanner

NPI #1699210088 in Holiday, Florida

Provider Information

NPI Number: 1699210088
Entity Type: Individual
Name: Lacie Wanner
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Enumeration Date: Dec 21, 2016
Last Updated: Dec 21, 2016

Practice Location

Address: 5331 WHIPPORWILL DR.
City: Holiday
State: Florida
ZIP Code: 34690
Phone: (218) 244-2405

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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