Individual
MRS. MICHELLE C LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
7171 N DALE MABRY HWY, TAMPA, FL 33614-2630
(813) 936-5075
Mailing address
6701 SPANISH MOSS CIR, TAMPA, FL 33625-6531
(813) 842-1928
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL1541
FL
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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