Individual
LUCAS URICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6636 E BASELINE RD STE 102, MESA, AZ 85206-4431
(480) 687-7751
Mailing address
6636 E BASELINE RD STE 102, MESA, AZ 85206-4431
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-014457
AZ
Other
Enumeration date
04/23/2022
Last updated
04/23/2022
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