Individual
NICHOLAS THOMAS AIVARS LUKASEVICS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5229 APPOMATTOX RD, PLEASANT GARDEN, NC 27313-8202
(336) 674-2252
Mailing address
3112 ABBOTTS CREEK CT, KERNERSVILLE, NC 27284-3742
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A5862
NC
Other
Enumeration date
10/16/2018
Last updated
10/16/2018
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