Individual
BENJAMIN LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT
Contact information
Practice address
100 W COLLEGE ST, GRANVILLE, OH 43023-1100
(937) 668-2689
Mailing address
100 W COLLEGE ST, GRANVILLE, OH 43023-1100
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT006228
OH
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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