Lisa Langley Stacy, PT | |
5179 Marsden Trce, Powder Springs, GA 30127-4321 | |
(678) 472-4042 | |
Not Available |
Full Name | Lisa Langley Stacy |
---|---|
Gender | Female |
Speciality | Physical Therapist - Pediatrics |
Location | 5179 Marsden Trce, Powder Springs, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851486070 | NPI | - | NPPES |
736506618A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2251P0200X | Physical Therapist - Pediatrics | 007304 (Georgia) | Primary |
Provider Name | The Weston Group Inc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1841309101 PECOS PAC ID: 8123936796 Enrollment ID: O20050719000195 |
Provider Name | Horizons Therapy Group, Inc. |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1720373020 PECOS PAC ID: 5496781627 Enrollment ID: O20110621000685 |
Mailing Address | Practice Location Address |
---|---|
Lisa Langley Stacy, PT 5179 Marsden Trce, Powder Springs, GA 30127-4321 Ph: (678) 472-4042 | Lisa Langley Stacy, PT 5179 Marsden Trce, Powder Springs, GA 30127-4321 Ph: (678) 472-4042 |
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