Individual
LUCAS ONDIMU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2045 N HWY 360 # 100B, GRAND PRAIRIE, TX 75050-1403
(972) 623-1111
Mailing address
3403 MAYFLOWER CT, ARLINGTON, TX 76014-3356
(817) 637-6756
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2180908
TX
Other
Enumeration date
03/15/2024
Last updated
03/15/2024
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