Doctor Name: | TRACY A. LACINA |
NPI Number: | 1952609034 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 0067686 |
Business Practice Address: | 2771 Oakdale Blvd Ste 8 Coralville, IA - 522419747 |
Business Phone Number: | 3199361319 |
Business Fax Number: | 3196653781 |
Mailing Address: | 2771 Oakdale Blvd. Ste. 8, CORALVILLE |
State: | IA |
Postal Code: | 52241 |
Phone Number: | 3199361319 |
Fax Number: | 3196653781 |
NPI Enumeration Date: | 03/14/2011 |
NPI Last Update Date: | 03/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 0067686 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |