Individual provider · NPI-1

Lacey Beth Anderson, DPT

Physical Therapist · Mission Viejo, CA

NPI number1144094574
StatusActive
Last updated in NPPESNov 7, 2023

Details

NPI
1144094574
Entity type
Individual (NPI-1)
Name
Lacey Beth Anderson
Credential
DPT
Sex
Female
Sole proprietor
No
Enumeration date
Nov 7, 2023
Certification date
Nov 7, 2023
Last updated
Nov 7, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist––Yes

Practice location

23296 La Mar Apt D
Mission Viejo, CA 92691-7837

Phone 805-368-1923

Mailing address

23296 La Mar Apt D
Mission Viejo, CA 92691-7837

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