Individual
LUCAS ROBINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
520 S EAGLE RD STE 1222, MERIDIAN, ID 83642-6355
(208) 947-2266
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1409
ID
Other
Enumeration date
09/22/2016
Last updated
05/23/2022
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