Individual
CHRISTY L LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
597 LIBERTY ST, WEST MILFORD, WV 26451-6801
(304) 745-4568
(304) 326-3700
Mailing address
597 LIBERTY ST, WEST MILFORD, WV 26451-6801
(304) 745-4568
(304) 326-3700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
661
WV
363AM0700X
Medical Physician Assistant
01085
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810010826
—
WV
01
—
P00466815
RAILROAD MEDICARE
WV
Enumeration date
10/23/2006
Last updated
08/31/2022
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