Individual
EVAN LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
175 N GROESBECK HWY, MOUNT CLEMENS, MI 48043-1562
(517) 442-2069
Mailing address
175 N GROESBECK HWY, MOUNT CLEMENS, MI 48043-1562
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704349985
MI
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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