Individual
JENNIFER C. LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
103 S PIONEER RD, FOND DU LAC, WI 54935-3871
(920) 922-7776
(920) 922-2938
Mailing address
103 S PIONEER RD, FOND DU LAC, WI 54935-3871
(920) 922-7776
(920) 922-2938
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6029-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40309500
—
WI
Enumeration date
08/18/2006
Last updated
07/08/2007
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