Lacey Delilah Slade, PTA

NPI #1932766052 in Jerome, Idaho

Provider Information

NPI Number
1932766052
Entity Type
Individual
Name
Lacey Delilah Slade, PTA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physical Therapy Assistant
Credential
PTA
Enumeration Date
May 23, 2019
Last Updated
May 23, 2019

Practice Location

Address
128 5TH AVE W
City
Jerome
State
Idaho
ZIP Code
83338-1863
Phone
(208) 324-3090

Specialties & Taxonomy Codes

Specialty
Physical Therapy Assistant

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