Individual
MONTANA LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
223 1/2 THORN AVE, MOUNDSVILLE, WV 26041-1248
(304) 650-5110
Mailing address
223 1/2 THORN AVE, MOUNDSVILLE, WV 26041-1248
(304) 650-5110
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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