Provider Demographics
NPI:1962748335
Name:STARR, LACEY D (DC)
Entity type:Individual
Prefix:DR
First Name:LACEY
Middle Name:D
Last Name:STARR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:LACEY
Other - Middle Name:D
Other - Last Name:GILLIES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:330 1ST ST STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-4683
Mailing Address - Country:US
Mailing Address - Phone:515-306-8174
Mailing Address - Fax:
Practice Address - Street 1:330 1ST ST STE 100
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-4683
Practice Address - Country:US
Practice Address - Phone:515-306-8174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-12
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007633111N00000X
MN5703111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor