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Individual
LUCAS PHILLIPS
Active
Individual
LUCAS PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED, ATC, LAT
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
3982
OH
2255A2300X
Athletic Trainer
36001524A
IN
Other
Enumeration date
11/01/2011
Last updated
03/27/2018
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