Individual
TIM R LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
138 S MAIN, AFTON, OK 74331
(918) 257-4244
Mailing address
114 W DELAWARE AVE, NOWATA, OK 74048-2601
(918) 273-1841
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/22/2018
Last updated
05/22/2018
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