Individual
LUCAS JOHN VALERIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
10640 269TH AVE NW, ZIMMERMAN, MN 55398-8522
(612) 840-5692
Mailing address
10640 269TH AVE NW, ZIMMERMAN, MN 55398-8522
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
119372
MN
Other
Enumeration date
08/04/2008
Last updated
08/04/2008
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