Individual
AMANDA BEAU LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2011 CORONA RD STE 207, COLUMBIA, MO 65203-2548
(573) 234-1000
(573) 234-1771
Mailing address
2011 CORONA RD STE 207, COLUMBIA, MO 65203-2548
(573) 234-1000
(573) 234-1771
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2006039114
MO
363A00000X
Physician Assistant
Primary
2025023979
MO
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/23/2007
Last updated
05/21/2026
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