Individual
LUCAS C REICHERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1126 W GRAYHAWK LOOP, ROOSEVELT, UT 84066-1209
(207) 659-8756
Mailing address
1126 W GRAYHAWK LOOP, ROOSEVELT, UT 84066-1209
(207) 659-8756
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4967790-4406
UT
367500000X
Certified Registered Nurse Anesthetist
AA103014
ME
Other
Enumeration date
07/14/2010
Last updated
01/23/2020
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