Individual
TONY LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2829 E HIGHWAY 76, MULLINS, SC 29574-6035
(843) 431-2000
Mailing address
PO BOX 603898, CHARLOTTE, NC 28260-3898
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
21813
SC
Other
Enumeration date
04/12/2018
Last updated
12/01/2020
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