IndividualActive
Jacob Lacey, CPO
NPI 1891524427 · Prosthetist · Wausau, WI
Provider details
- NPI number
- 1891524427
- Entity type
- Individual
- Primary specialty
- ProsthetistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CPO
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1815 Stewart Ave
Wausau, WI 54401-5373
Phone: (715) 849-8703
Approximate (ZIP-level) locationGet directions
Mailing address
1815 Stewart Ave
Wausau, WI 54401-5373
Registry dates
- Enumerated
- 2024-07-31
- Last updated
- 2024-07-31
- Certified
- 2024-07-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.