Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lacey Antonio, PTA

Individual provider Physical Therapy Assistant · NPI 1679233100

Lacey Antonio, PTA is a Physical Therapy Assistant in Leesburg, Georgia. Practices as a sole proprietor. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

1360 Lovers Lane Rd
Leesburg, GA 31763-4544
Phone: (229) 881-2594
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X

Record details

NPI number1679233100
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedDecember 24, 2021
Last updated in NPPESDecember 24, 2021
Certification dateDecember 24, 2021
Mailing address1360 Lovers Lane Rd, Leesburg, GA 31763-4544

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