Individual
KELLY LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27225 N 47TH ST, CAVE CREEK, AZ 85331-2655
(757) 812-3428
Mailing address
1930 E SOUTHERN AVE, TEMPE, AZ 85282-7518
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11782PT
AZ
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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