| Doctor Name: | LACEY I GODBOLD |
| NPI Number: | 1780972281 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 07633 |
| Business Practice Address: | 2600 Belle Chasse Hwy Suite I Terrytown, LA - 700567156 |
| Business Phone Number: | 5043917670 |
| Business Fax Number: | 5043789437 |
| Mailing Address: | 2600 Belle Chasse Hwy, Suite 208 TERRYTOWN |
| State: | LA |
| Postal Code: | 700567156 |
| Phone Number: | 5044338744 |
| Fax Number: | 5044338740 |
| NPI Enumeration Date: | 07/18/2011 |
| NPI Last Update Date: | 02/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 07633 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |