Individual
MR. LUCAS KIEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
442 W ALPHA ST, ROSEBURG, OR 97471-2523
(541) 530-2101
Mailing address
442 W ALPHA ST, ROSEBURG, OR 97471-2523
(541) 530-2101
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OR
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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