Individual
LUCAS J. GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
313 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25303-1263
(304) 744-2300
(304) 744-8195
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(304) 744-2300
(304) 744-8195
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002315
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000217253
ANTHEM BCBS
—
01
—
001720908
MOUNTAIN STATE BCBS
—
05
—
7302399000
—
WV
01
—
P00017315
RR MEDICARE
—
Enumeration date
07/13/2006
Last updated
08/08/2011
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