Individual
LUCAS MARK SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(866) 989-7999
Mailing address
3804 YORKLAND DR NW APT 9, COMSTOCK PARK, MI 49321-8892
(231) 360-1940
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
175899
—
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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