Jacob Lacey, CPO

NPI #1891524427 in Wausau, Wisconsin

Provider Information

NPI Number: 1891524427
Entity Type: Individual
Name: Jacob Lacey, CPO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Prosthetist
Credential: CPO
Enumeration Date: Jul 31, 2024
Last Updated: Jul 31, 2024

Practice Location

Address: 1815 STEWART AVE
City: Wausau
State: Wisconsin
ZIP Code: 54401-5373
Phone: (715) 849-8703

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Prosthetist	224P00000X	Primary

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