Individual
CODY LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
300 COLLEGE PARK AVE, DAYTON, OH 45469-0001
(937) 229-4437
Mailing address
4203 CASA BLVD, GROVE CITY, OH 43123-3424
(614) 634-8608
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
004395
OH
Other
Enumeration date
08/26/2015
Last updated
08/26/2015
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