Individual
MISS DELAINA LUCUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
(601) 605-6777
(601) 605-8869
Mailing address
510 N 38TH AVE APT 59, HATTIESBURG, MS 39401-5732
(601) 296-0411
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2694
MS
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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