Individual
MR. LUCAS TYLER SHAMMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
2221 HAYES AVE, FREMONT, OH 43420-2632
(419) 334-3869
Mailing address
211 KIMBERLY LN, CLYDE, OH 43410-1892
(419) 307-0015
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
APRN.CNP.0031455
OH
Other
Enumeration date
06/03/2022
Last updated
06/07/2022
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