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

Lacey Powell

Individual provider Physical Therapist · NPI 1114601473

Lacey Powell is a Physical Therapist in Private Practice in Myrtle Beach, South Carolina. Qualified in 2023, 3 years ago. Practices with Back in Form Physical Therapy Inc, a 5-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2023
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Practice location Address checks out

108 Debo Dr Ste 130
Myrtle Beach, SC 29579-4918
Phone: (843) 796-2850
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1114601473
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 14, 2023
Last updated in NPPESJune 14, 2023
Certification dateJune 14, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Back In Form Physical Therapy Inc. — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Myrtle Beach