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General NPI Number Information
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NPI Number | 1023246618
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Entity Type | Individual
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Provider Name | LACY D JENNINGS PT
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Gender | Male
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 1325 S COLORADO BLVD
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City | DENVER
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State | CO
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Zip | 80222-3303
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Country | US
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Telephone | 303-394-3356
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Fax |
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Provider Business Mailing Address
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Address Line | 1108 DRESSER CT SUITE 201B
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City | RALEIGH
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State | NC
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Zip | 27609-7328
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Country | US
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Telephone | 919-876-8302
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Fax | 919-954-8706
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PTL.0012620
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 12122
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License Number State | NC
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