Individual
JOHN LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
2716 W CENTRAL AVE, WICHITA, KS 67203-4904
(316) 660-7357
(316) 660-1928
Mailing address
635 N MAIN ST, WICHITA, KS 67203-3602
(316) 660-7600
(316) 660-7510
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
25764
KS
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
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