Individual
LUCIUS WILLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3401 YORKSHIRE MEDICAL PARK, LEXINGTON, KY 40509-2513
(859) 263-5140
Mailing address
634 BRAMBLEWOOD DR, CORBIN, KY 40701-7427
(606) 627-6426
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT643
KY
Other
Enumeration date
05/13/2018
Last updated
05/13/2018
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