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Individual
LUCAS HOWARD CARLSON
Active
Individual
LUCAS HOWARD CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
007100
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629229711
BCBS
IA
05
—
1629229711
—
IA
Enumeration date
10/07/2008
Last updated
01/06/2010
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