NPI 1891524427

Jacob Lacey, CPO

Practitioner Prosthetist Wausau, WI

Practice location

Address: 1815 Stewart Ave, Wausau, WI 54401-5373
Phone: (715) 849-8703

Registered specialties

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

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Registry record

NPI: 1891524427
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Jul 2024
Record last updated: 31 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.