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Contact Information

LACI D JOHNCOCK
2786 56TH STREET
WYOMING, MI49418
 Phone: 616-261-3960
 Fax: 616-261-3925
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy Assistant

225200000X
Indicates primary specialty

NPI Profile & details for LACI D JOHNCOCK · (Female)

NPI # 1972989655
Status Active
Credentials
Entity Individual
Enumeration date 08/05/2015
Last updated 08/05/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 5502003277
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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