Individual
SAMANTHA JEAN LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6101 16TH ST, RACINE, WI 53406-4467
(262) 898-2770
Mailing address
6101 16TH ST, RACINE, WI 53406-4467
(262) 898-2770
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2145
WI
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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