Individual
LUCAS JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LDO, ABOC, NCLEC
Contact information
Practice address
3221 W 86TH ST, INDIANAPOLIS, IN 46268-3606
(317) 872-3230
(317) 876-3208
Mailing address
3221 W 86TH ST, INDIANAPOLIS, IN 46268-3606
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO6993
FL
Other
Enumeration date
09/26/2024
Last updated
09/26/2024
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