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Individual

RYAN JON LUCAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1001 GORNICK AVE, GAYLORD, MI 49735
(989) 732-1533
(989) 732-0629
Mailing address
1001 GORNICK AVE, GAYLORD, MI 49735
(989) 732-1533
(989) 732-0629

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
RL008659
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4811820
MI
Enumeration date
10/04/2006
Last updated
08/30/2012
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