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Organization

LUCAS PHYSICAL THERAPY INC

Active
Other names
Lucas Therapies PC
Organization subpart
No

Provider details

NPI number
Authorized official
AMANDA STREETER (VICE PRESIDENT)
(800) 699-9395
Entity
Organization

Contact information

Practice address
4325 BRAMBLETON AVE STE A, ROANOKE, VA 24018-3404
(540) 772-8022
(540) 772-0294
Mailing address
PO BOX 932184, ATLANTA, GA 31193-4912

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
225XH1200X
Hand Occupational Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
193431
ANTHEM PT GROUP #
VA
01
193434
ANTHEM PT # LOC 2
VA
01
193437
ANTHEM PT # LOC 3
VA
01
193442
ANTHEM PT # LOC 5
VA
01
249624
ANTHEM PT # LOC 6
VA
Enumeration date
02/07/2007
Last updated
12/04/2023
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